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Study: Doctor burnout may increase effect of biases on care

Doctors said bureaucratic tasks, working too many hours, computerization, and dealing with insurance are among aspects of the job most burning them out.

By Stephen Feller

WASHINGTON, Jan. 13 (UPI) -- A national survey of doctors shows job burnout and personal bias have continued to increase in recent years, and researchers suggest the growth of both could affect the quality of care patients receive.

Doctors said bureaucratic tasks, working too many hours, computerization, and dealing with insurance as among aspects of the job most burning them out, in the survey conducted by MedScape. These, and other, aspects may also increase the way that personal and other biases such as emotional problems, weight, and intelligence.

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Researchers wrote in the report that the new survey echoes other recent surveys and "strongly suggests that burnout among U.S. physicians has reached a critical level. Burnout is generally defined as loss of enthusiasm for work, depersonalization, and a low sense of personal accomplishment."

A 2012 study showed nearly half of physicians reported at least one symptom of burnout, and found "frontline" workers, such as those in the emergency room, had the greatest risk for burning out.

Medscape researchers surveyed more than 15,800 physicians in 25 specialties across the United States, asking about aspects of burnout, reasons, bias toward types of patients, and whether the two are related.

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The highest percentage of physicians reporting burnout were in critical care, urology, and emergency medicine, as 55 percent of survey participants in those categories said they felt at least one aspect of burnout. All three represent increases in the percentage of doctors reporting burnout, the largest of the three coming from urologists. Family medicine and internal medicine were fourth and fifth on the list at 54 percent.

For biases, 62 percent of doctors said they were put off by emotional problems in patients, 52 percent reported a bias based on weight, 44 percent reported bias based on intelligence level, and 32 percent reported bias based on language differences.

A small percentage of doctors admitted their biases affected the care they provide, with 14 percent of emergency medical doctors and 12 percent of plastic surgeons at the top of the list. More than 10 percent of orthopedists, family physicians, psychiatrists, and rheumatologists also admitted their biases affected their care.

More doctors who expressed burnout, 43 percent, said they also had biases, while 36 percent of physicians without burnout admitted to bias. The two, researchers suggest, may be related as doctors who are burned out are more likely to have less patience for emotional or difficult patients -- regardless of reported biases.

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In addition to individual help for physicians, researchers said efforts to improve patient satisfaction also help improve physician burnout. Improving systems for delivering medical treatment are part of fixing the problem, researchers write.

"Interventions for physician burnout are typically psychologically oriented and skewed toward the individual, although strong evidence suggests that what's needed are systemic changes in the way physicians are trained and in the organizational cultures that affect physicians throughout their careers," researchers wrote in the report.

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