Health Services Research & Policy ■ Clinical Practice Management ■ Training & Education ■ Leadership
Health Services Research & Policy ■ Clinical Practice Management ■ Training & Education ■ Leadership
Health Services Research & Policy
■ Clinical Practice Management
■ Training & Education ■ Leadership

Linking Quality of Care and Burnout

  We need to talk about how physician burnout affects patients too.

There are many reasons to be concerned with the current epidemic of burnout – included amongst these are patient satisfaction, staff turnover and diminished quality of teamwork, efficiency, health care costs, personal consequences including psychological and physical ailments, staff and patient safety, and medicolegal risks. One of the lesser-discussed effects of burnout relates to the quality of the care that we deliver. If we drill down into the data, burnout among surgeons predicts major medical errors (and even future errors), which can then lead to malpractice suits. I imagine these results are also applicable to radiologists.

The vicious cycle of errors worsens the extent of burnout, depressive symptoms, and quality of life, all components of being a second victim of our own errors. Anecdotally, I see physicians asking to settle more suits rather than fight them, another unanticipated manifestation of stress in our workplace. As we continue to focus our attention on improving the quality of care we provide, we must not forget about the care of the provider, the so-called 4th aim of healthcare. In a recent Medscape survey, 47 percent of radiologists said they were either burned out, depressed, or both. Interestingly, 42 percent of radiologists who reported depression also believed their depression did not affect their interactions with patients. However, 32 percent reported being less engaged with patients, and 12 percent said they make errors that could harm patients.

The connection between physician wellness and patient outcomes is clear. What isn't clear is how we deal with this as a specialty.

"Burnout is like a fever," wrote Dr. Richard Gunderman. "One response to a fever is simply to treat it with an antipyretic, with the expectation that it will go away. Doing so, however, may only delay the detection of an underlying disorder, such as an infection or a malignancy, which requires a more definitive form of therapy. To focus purely on the symptom and its treatment is to overlook a more important opportunity to address the underlying cause."

We must recognize staff engagement and wellness as a cornerstone of the quality of care we deliver. Including individual, practice, or even organizational wellness as a quality indicator is something we need to embrace now. 

ACR Annual Conference on Quality and Safety

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Thursday, 18 July 2019

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