Watch for burnout in the physician community | Laura Knight

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This opinion column was submitted by Dr. Laura Knight, chief medical examiner and coroner at the Washoe County Regional Medical Examiner’s Office.  

I deal daily with death and unfortunately see suicides regularly; it’s the nature of my job, and some might say an occupational hazard. It’s particularly heartbreaking when it’s a person I have known, or a physician colleague in the community.

Many Americans are gaining a clearer picture of the burnout health care providers face while our national dialogue centers around the medical industry almost daily. But what they might not know is that burnout isn’t new. Physician burnout is, however, compounding during the exacerbating conditions of the pandemic and contributes to a startling consequence: physician suicide. Sadly, physicians are more than twice as likely to die by suicide compared with the average American, and added stressors like the pandemic have the potential to worsen this statistic. Already, nearly half of physicians are reporting they feel burned out, according to the 2020 Medscape National Physician Burnout & Suicide Report.

I’m writing to you as a board member for Nevada Physician Wellness Coalition, where we hope to raise the volume on the issue that physician burnout has become during this pandemic. Even before COVID-19 entered our area, Nevada was dealing with a physician shortage. In order to fully service the state of Nevada, it is estimated that we need an additional 2,500 physicians. In my field, less than half the needed number of forensic pathologists (medical examiners) exist in the U.S. As it stands, there are too few doctors shouldering a tremendous workload across the board.

Underscoring the typical pressures of the medical world are factors like burdensome educational debt outpacing wages, and increased productivity demands in the face of decreased time with patients.  Physicians deal with complex reporting requirements, continuous education and certification, insurance authorizations and other red tape, and the demands of completing electronic health records on top of arduous and draining shifts. Add to this a virus that is not yet well understood, moving into what may be an unprecedented and difficult fall and winter season, dealing with the challenge of treating COVID patients while trying to keep from contracting the disease themselves, and you have a very complicated set of stressors.

Despite the complexities, I can vouch for the fact that Nevada physicians will continue honoring the oaths they made at the start of their careers, even when it comes at high cost to themselves. As physicians, we must support one another and rely on our community as well; we must guard against burnout robbing us of highly valued and much needed physicians. Nevada Physician Wellness Coalition seeks to fill a gap and a clear need among physicians for greater support.

Please watch for the signs of burnout (depression, distancing from loved ones and increased irritability) and seek help. Nevada Physician Wellness Coalition offers an anonymous resource line, exclusively for physicians and family members of physicians (that confidentially provides options, guidance and referrals for those looking to take those steps. That number is 775-404-3307. Nevada Physician Wellness Coalition (www.nevadaphysicianwellnesscoalition.com) was created expressly to help in this regard. This nonprofit organization is a go-to support system for physicians and their families, and wellness offerings include: 

• An anonymous resource line (775-404-3307) where physicians can speak confidentially with a psychologist to identify next steps or receive a referral for additional help. 
• A gratitude wall, where we invite you and the rest of this community to provide kudos to our doctors to remind them their efforts are appreciated and necessary. 
• A library of mental health and wellness articles physicians or for loved ones concerned with spotting additional signs of burnout.
• An ongoing lecture series by physicians for physicians on topics relevant to mental wellness and burnout.

Whether you’re the one exhibiting signs of burnout or those signs are manifesting in a colleague or loved one, help is available. The medical community right now needs as many capable hands as we can manage. If we fail our doctors now, our collective health will suffer devastating consequences. 

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