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It’s time for burnout to become a quality metric

Trina E. Dorrah, MD
Physician
November 1, 2023
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I completed a fellowship in quality improvement, making quality metrics an integral part of my career for the past 15 years.

At times, these metrics can be frustrating, especially when reimbursement is tied to constantly shifting targets.

Yet, health systems invest hundreds of thousands of dollars in order to improve quality metrics because Medicare mandates it.

This led me to contemplate:

What if Medicare included burnout as a quality metric?

What if health systems were obliged to measure physician burnout and implement measures to mitigate it?

What if hospital reimbursement was directly linked to physician burnout scores and turnover?

How much funding would health systems allocate to reduce burnout in that scenario?

Imagine the transformation of health care in America if Medicare incorporated burnout as a national quality metric.

It is estimated that 300 to 400 physicians die by suicide each year.

How many of our colleagues could be saved if reducing burnout and moral injury became a quality metric with financial penalties for health systems that fail to address it?

What makes this idea even more promising is that there is already an evidence-based intervention—coaching—that has been shown to be effective. Another article was published this week in JAMA, demonstrating the efficacy of coaching.

The article, “Online Wellbeing Group Coaching Program For Women Physician Trainees,” is a randomized clinical trial published in one of the world’s most prestigious journals. It reveals that coaching leads to statistically significant reductions in burnout, moral injury, and imposter syndrome.

On Medicare’s website, they state that they use quality metrics to ensure the delivery of high-quality care.

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I can’t think of a better quality metric to introduce than holding health systems accountable for reducing burnout among their physicians and non-physician staff.

Trina E. Dorrah is an internal medicine physician.

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