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Doctors in training are fatigued

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This month, the American Medical Association invested $15 million in eight ambitious programs to address the workplace needs of our health system. Among the goals: addressing the crisis of burnout among training physicians by investing in wellness innovations. In many ways, it is an issue as important and consequential as President John F. Kennedy’s moonshot program that became fully realized 50 years ago this summer.

In Septemer 1962, when Kennedy stood in Houston and said, “We choose to go to the moon in this decade and do other things, not because they are easy, but because they are hard,” he echoed a call to action that required the collaboration of a nation. Shortly after his 1961 inauguration, Kennedy had pledged to commit the nation to the moon program. Crystallizing his thinking under the Texas sun a year later, he said, “because that goal will serve to organize and measure the best of our energies and skills.”

Just as Kennedy saw that an urgent national problem can be solved with an ambitious national response, the American Medical Association aims as high with the urgent problem of physician well-being.

American physicians are weary, and it is affecting the health of our nation.

Half of practicing physicians experience burnout. Among physicians in training, up to 70 percent report symptoms of burnout. Numerous studies have shown that burnout hurts clinical performance. And poor clinical performance risks the heath of patients. What is less clear, though, are the reasons for this blight and how to fix them. In early 2019, the National Academy of Medicine identified the relationship between the learning environment and resident physician well-being as an area that needs study. The AMA Reimagining Residency grant has now given training programs an opportunity to do just that.

Like Kennedy’s collaboration in the 1960s, we are partnering with institutions across the country to study the problem. Our hypothesis is that increasing the time physicians spend directly with their patients will improve well-being and clinical skill. The task will not be easy. Studies show residents have far more continuity with a digital description of their patient than the actual person.

We believe the public deserves the same rigor of evidence in how to best train our physicians as it demands for foundational science. Working with residency programs, we will create a graduate medical training laboratory to identify associations between the learning environment and burnout and clinical skill. Informed by these data, we will design and test interventions and prepare residents to practice patient-centered medicine for the 21st century.

We believe we must invest in the medical moonshot, not because it is easy, but because it is hard. But more than that, because of what it will make of us in obtaining this information. Just as Kennedy’s space exploration investment yielded unanticipated innovations in technology and teamwork, we hope the AMA’s investment in medical education also will yield a renaissance of physician and patient communication during every clinical encounter. If in pursing this medical moonshot we serve to “measure the best of our energies and skills,” the health of a nation will surely notice.

 Dr. Stephen Russell is associate professor of medicine and pediatrics at the University of Alabama at Birmingham. Dr. Sanjay Desai is vice chair for education within the Department of Medicine at the Johns Hopkins University School of Medicine, where Dr. Brian Garibaldi is associate professor of medicine. They wrote this piece for The Baltimore Sun.

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