ACR president: ‘All of us in rheumatology are embattled’ with burnout
ATLANTA — Rheumatologists across the United States are currently besieged by a combination of time-consuming administrative work, restricted autonomy and a loss of community, all of which have contributed to burnout throughout the specialty, according to Paula Marchetta, MD, MBA, president of the American College of Rheumatology.
“Right now, all of us in rheumatology, and indeed all of us in health care, are embattled,” Marchetta told attendees at the opening ceremony of the 2019 ACR/ARP Annual Meeting. “We struggle to win the limited dollars available to fund innovative research which will advance our knowledge of the pathways to cure our diseases. We must fight so that our patients can receive the necessary treatments which will spare them from pain, loss of function and disability. We are shackled to our electronic medical record and forced to be more engaged with our computer screen than with our patients.”
“We decry the forces which threaten our autonomy as clinicians and as scientists,” she added. “And at a time when access to rheumatologic care is more and more constrained by the workforce shortage, we must allocate our hours to burdensome administrative tasks, which have little to do with why we chose rheumatology. We become physically exhausted and emotionally depleted by these battles, even as we recognize the importance of collecting our data, reporting our outcomes and demonstrating the value of our specialty to those who still may ask, ‘What is rheumatology?’”
All of this, Marchetta said, are just some of the elements that have laid the groundwork for the rise in physician burnout throughout the United States. This has, in turn, led to negative downstream effects on patient safety, satisfaction and quality of care, she added.
To combat these developments, Marchetta said she could only offer her perspective as someone who spent her career in clinical practice, as a witness to the changes that have taken hold across rheumatology practices.
“From this perspective, I was struck by one observation, so obvious that it is easy to overlook,” she said. “It commanded my attention as if written in boldface: The disappearance of the doctors’ lounge.”
Although her observation was initially met with some laughter, Marchetta went on to argue that the loss of the physicians’ lounge in many — if not most — hospitals has coincided with a lost sense of community and support among rheumatologists.
“This physical space has been the victim of greater work demands, productivity expectations and a need to repurpose the space for other, more efficient uses,” Marchetta said. “Its insidious loss has not only been cited as one of the reasons for burnout, but also as the underpinning of some of its most disheartening symptoms — professional loneliness, isolation and disillusionment.”
These spaces had previously offered physicians a place to share their common experiences, unique to their profession and specialty, which fostered a sense of community and collegiality.
Regaining this sense of community, she said, could potentially be the key to combatting the growing problem of burnout.
“The need for us to regain a sense of community in our professional lives, to recapture a feeling of belonging, has never been greater than now,” Marchetta said. “When so many of the designated venues where we had once been supported by, and connected to, our peers have disappeared. Our professional society cannot really replace the lost doctors’ lounge, but in some ways, it transcends it. The ACR is home to all of us who reside within the house of rheumatology.”
She added, “This inclusivity, this bringing together of all these diverse aspects of our profession, into one organization sets the ACR apart, and builds for us a level of support, collegiality and respect for the views of others in our specialty in a way that lifts us all and helps to restore us.” – by Jason Laday
Marchetta P. 2S008 Opening Lecture & Awards. Presented at ACR/ARP Annual Meeting, Nov. 8-13, 2019; Atlanta.