US Surgeon General Issues Advisory on Healthcare Worker Burnout

Sarasota, FL (WorkersCompensation.com) – While a recent bill, Safety From Violence for Healthcare Employees (SAVE) Act, has been introduced to protect healthcare workers from workplace violence, more work may need to be done to support the struggling healthcare industry.

Taking a stance that the nation’s health depends on the well-being of all of our healthcare workers, earlier this month the U.S. Surgeon General issued an advisory warning on the record levels of burnout among healthcare workers. In addition to the effects of burnout on the individual workers themselves, the advisory notes that the high level of burnout can pose a threat to the nation’s healthcare infrastructure through multiple side effects. In what sometimes feels like an unsustainable system, even prior to the pandemic in 2019, a report from the National Academy of Medicine found that 54 percent of practitioners, and 60 percent of medical students reported symptoms of burnout. Additionally, researchers found that even prior to pandemic, 1 in 15 physicians had entertained suicidal thoughts, and were less likely to seek counseling.

According to the Surgeon General report, burnout among healthcare workers can ultimately create other issues such as decreased time in patient care, increased medical errors and infection rates. The annual estimated cost of burnout-related turnover is $9 billion for nurses and $2.6 to $6.3 billion for physicians, and that’s not including other healthcare workers. Additionally, the Association of American Medical Colleges (AAMC) estimates a shortage of 54,100 to 139,000 of physicians by 2033, with primary care and rural communities impacted the most.

The report listed possible negative consequences in workers with burnout, including insomnia, heart disease and diabetes, as well as increase substance abuse, and exhaustion. Side effects affecting patients, healthcare systems and the community include delays in care and diagnosis, lower quality of care, access to care, decreased patient satisfaction – which affects outcomes, increased cost, erosion of trust, increased health disparities, and lack of preparedness in a public health crisis.

Multiple factors contributing to workers feeling helpless and burnt out were highlighted in the report. Societal and cultural factors included politicization of health and science, health misinformation, racial inequities, mental health stigma, and unrealistic expectations of healthcare workers. Healthcare system factors included limitations of federal and state regulations, unfair reimbursement policies, burdensome administrative duties, poor care coordination, and lack of human-centered technology.

Organizational factors included lack of leadership support, disconnect between values and key decisions, excessive workload and hours, biased structures and practices, and barriers to mental health and substance abuse care. Workplace factors included limited flexibility and autonomy, a lack of collaboration and vulnerability, limited time with patients and colleagues, lack of focus on worker mental health, and discrimination and harassment.

The report found that certain groups of healthcare workers have been disproportionately impacted by burnout. Those healthcare workers that have asn inordinate amount of burnout levels include workers of color, Immigrant healthcare workers, females, low wage workers, rural healthcare workers, and tribal healthcare workers.

Workers of color are more highly represented among low wage positions. During the pandemic, they were twice as likely to test positive for COVID-19 due to care exposure, and were more likely to not have appropriate protective gear.

Immigrant workers make up 38 percent of home health aides, 25 percent of personal care aides, 18 percent of healthcare workers overall, and one third of physicians. According to the report, over a third of healthcare workers that died during the pandemic were immigrant workers.

Females make up 70 percent of workers in healthcare, and report higher levels of burnout, depression and anxiety, insomnia, and occupational distress. Nine out of ten lower wage workers are female, and two-thirds are minorities. Additionally, one-third of low wage workers live below the federal poverty line. Food insecurity is 5.1 time higher for health support workers, and 2.5 times higher for technologists compared to clinical practitioners.

The advisory urged organizations to shift their thinking about burnout from an individual worker problem to an organizational and national level problem. The report includes resource tools for assessing burnout, and extensive suggestions on implementing protocols for supporting mental health, ensuring workers felt heard and valued, and avoid violence and abuse in the workplace. Additionally, the report included strategies for prioritizing time with patients, reducing administrative burdens, and increasing flexibility. Strategies for promoting diversity, equity, inclusion, and accessibility and deterring discrimination were also discussed.

Also Included in the extensive report is a helpful grid of resource links from the National Academy of Medicine Collaborative Resource Compendium for Health Worker Well-Being.

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