Identifying and Preventing Burnout in Healthcare Professionals

Work Related Stress and Burnout in Healthcare Professionals – A Stark Reality

Even before the COVID-19 pandemic, the world faced a looming healthcare crisis – a shortage of healthcare professionals. And in an attempt to make up for the disparity between demand and supply, the ones in the healthcare system are toiling harder, leading to overwork and stress. As per the World Health Organisation (WHO) estimates, there will be a shortage of 18 million health workers by 2030 globally, with nurses making up half of this gap. Furthermore, exhaustion, “burnout”, and over six million deaths from the coronavirus only worsened and deepened the woes of the healthcare workers.

Burnout – a term coined by psychoanalyst Freudenberger in the early 1970s, is a syndrome resulting from prolonged exposure to work-related stress and has adverse consequences on healthcare professionals and the organizations where they work. The syndrome is associated with emotional exhaustion, sleep deprivation, cynicism and depersonalization, medical errors, and reduced professional efficiency and personal accomplishments.

To delve deeper into the subject and attempt to spread awareness about preventing and treating burnout, Equitable Healthcare Access Consortium (EHAC), a not-for-profit organization, spoke to healthcare experts to get a broader perspective.

“Microaggression and annoyance are part and parcel of any profession. For burnout, internal and external factors play a critical role. An organization needs to value every individual in the system. Moreover, we need to make a cultural shift where people do not consider emotional problems a stigma. There is a dire need to spread awareness among people, legislators, and systems around it. If healthcare systems do not realize that preventive and primary care are crucial, we will repeat the same problem,” said Dr. Ravi Kolli, MD. Senior Psychiatrist from the USA, Medical Director SPHS, and President-elect, the American Association of Physicians of Indian Origin.

Prof. Parag Singhal, Consultant Endocrinologist, National Secretary British Association of Physicians of Indian Origins (BAPIO), had a similar opinion. According to Parag, most of the junior doctors in his hospital complain that they are frustrated because only 20 percent of their job is about seeing the patients, and 80 percent entails maintaining the records of the patients for angiograms. As per the Indian Journal of Psychiatry, 30 percent of Indian doctors and physicians go through depression, 17 percent have experienced thoughts of ending their life, and 80 percent, especially at the earlier stages of their career, face burnout risk. Therefore, doctors are experiencing “micro irritations” and aggressions leading to frustration, self-doubt, and burnout.

Spreading awareness around the condition and developing coping organizational and personal strategies are critical in dealing with the problem. The question is; how can one combat and prevent burnout? Unfortunately, in India alone, one-fourth of healthcare workers suffer from burnout.

Sharing his experience as a healthcare administrator who has dealt with the waves of the Covid Pandemic, Dr. Raj Gopal Reddy, Director of Operations, Chandan Hospital Lucknow added, “We need to stop it from happening rather than waiting for it to happen. Patients’ expectations from doctors have increased during covid. Our hospital has made a systematic change – we ask doctors to explain everything and worst-case scenarios to patients beforehand. If you, do it continuously, the patient starts trusting you. Talking about the uncertainties in medicine will automatically reduce stress.”

Highlighting the importance of prevention was Dr. C S Pramesh, Professor Thoracic Surgery & Director Tata Memorial Hospital, Mumbai. He said, “Burnout is one area where prevention is better than cure. Organizations should take a step back and avoid burnout in the first place, and it is about creating an enabling work environment. While counselling your staff is one mechanism to prevent burnout, the condition is not related merely to the work we do. Several other factors, such as how you are meeting the aspirations of your workforce and valuing their work, are also important. We are so engrossed with patient care that we ignore the happiness of our employees. There should be a special focus on physicians handling areas like palliative and cancer care as they are the high-risk cohort,”

The COVID-19 pandemic has been a huge accelerator for the adoption of various technologies in healthcare that would have taken decades to be used extensively. From intelligent triage tools that collected data on patients’ medical histories and symptoms and made recommendations on who should receive an emergency room first to algorithms optimizing ventilator supplies by predicting which hospitals needed them at which times machines have never influenced patients’ lives to this extent, ever before.

Shedding light on the integration of Artificial Intelligence (AI) and Healthcare was Mr. Ankit Modi, Computer Scientist, AI Researcher, and Founding Member Qure.ai. His thoughts were, “Through Artificial Intelligence (AI), we want to make doctors spend more time with patients and take away the mundane tasks on their plates right now. For example, AI can help in reporting X-rays. If 15 out of 30 X-rays are normal, AI enables the radiologist to focus on the remaining 15. We now have AI-powered technologies that analyze chest CT scans for lung cancer that provide an automated interpretation and complement the care pathway management platform. Faster and more accurate detection helps decrease treatment time and improves patient outcomes.”

Dr. Shweta Jaiswal, Senior Intensivist and General Manager EHAConsortium, expressed her views on the increased burnout in women healthcare professionals. “Women in India face more stress, which further increased during the pandemic. Intensive care work was difficult; corporate hospitals provided PPEs, but healthcare professionals were working with insufficient supplies in other places. Frontline workers were under double stress to take care of their loved ones and patients, and many of my colleagues took a sabbatical due to burnout.” She further added that as female nurses are the predominant workforce, more importance should be given to the issue of burnout in them.

A survey by the National Center for Biotechnology Information, involving 2026 healthcare professionals from India, revealed that the prevalence of burnout due to personal reasons was 44.6 percent, work-related stood at 26.9 percent and 52.8 percent had pandemic-related burnout.