Surgeon General advisory sounds warning on healthcare worker burnout, resignation

Photo: AlenaPaulus/Getty Images

With a projected shortage of nearly 140,000 physicians by 2033, and a shortage of three million lower-wage healthcare workers in the next five years, U.S. Surgeon General Dr. Vivek Murthy has sounded the alarm on the country's ongoing healthcare burnout crisis.

Health workers – including physicians, nurses, community and public health workers, and nurse aides – have long faced systemic challenges in the healthcare system, even before the COVID-19 pandemic. That, according to Murthy, is leading to crisis levels of burnout.

The pandemic, of course, only made things worse, prompting Murthy to issue an advisory for addressing health worker burnout that includes recommendations such as reducing administrative burdens, being more responsible to workers' needs and eliminating punitive policies for seeking mental health and substance use disorder care.

Specifically, Murthy advised that hospitals and health systems should listen to workers and seek their involvement to improve workflows and organizational culture. On the mental health front he called for ensuring on-demand counseling and increased accessibility to after-work care.

Reducing the administrative burden is essential, he said, because a workers time should be spent with patients in the community and building relationships with colleagues. Murthy cited research showing this isn't always the case, with one study revealing that, on average, primary care workers will spend two hours a day on administrative tasks for every one hour of direct patient care.

Among other recommendations, the advisory suggested healthcare organizations provide all workers with living wages, paid sick and family leave, rest breaks, evaluation of workloads and working hours, educational debt support, and family-friendly policies including childcare and care for older adults. It also advocated for adequate staffing, including surge capacity for public health emergencies.

The Surgeon General also recommended that health systems prioritize social connection and community as core values, and diversify and expand the public health workforce while improving disease surveillance systems to help address social determinants of health and health inequities.

WHAT'S THE IMPACT?

Even before the COVID-19 pandemic, health workers were experiencing significant burnout – broadly defined as a state of emotional exhaustion, depersonalization, and low sense of personal accomplishment at work. Burnout can also be associated with mental health challenges such as anxiety and depression. 

In 2019, the National Academies of Medicine reported that burnout had reached "crisis" levels, with up to 54% of nurses and physicians, and up to 60% of medical students and residents suffering from burnout.

The pandemic has since affected the mental health of health workers nationwide, with more than 50% of public health workers reporting symptoms of at least one mental health condition, such as anxiety, depression and increased levels of post-traumatic stress disorder.

Already, Americans are feeling the impact of staffing shortages across the health system in hospitals, primary care clinics and public health departments. With over half a million registered nurses anticipated to retire by the end of 2022, the U.S. Bureau of Labor Statistics projects the need for 1.1 million new registered nurses across the U.S. And within the next five years, the country faces a projected national shortage of more than three million low-wage health workers.

The Association of American Medical Colleges projects that physician demand will continue to grow faster than supply, leading to a shortage of up to 139,000 physicians by 2033, with the biggest gaps occurring in primary care.

THE LARGER TREND

The Department of Health and Human Services said in January that American Rescue Plan money is funding $103 million to 45 grantees over three years to retain healthcare workers and to address burnout. The funds will also promote mental health and wellness and also go to training, with a focus on underserved and rural communities.

The funding adds to previous workforce investments such as residency programs.

COVID-19 has compounded rates of depression and anxiety among healthcare workers, according to HHS. The relentless physical and emotional demands of treating patients during a pandemic have exacerbated long-standing barriers to workplace wellbeing.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com