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36 Physician stress and burnout- cause or consequence of overdiagnosis?
  1. Ananta Dave
  1. National Health Service (NHS), Birmingham, UK

Abstract

There is emerging literature about possibly inceasing rates of burnout and stress among doctors from all specialties (Gerada, 2017), and in various regions of the world, though it has been studied more in the developed world. For instance burnout has been linked to higher rates of prescribing (Shanafelt and Noseworthy, 2016). Burnout can adversely affect quality of clinical practice and decision making and therefore there is a moral and ethical imperative to address this issue (Imison, 2018).

In this session, the various reasons why burnout may lead to overdiagnosis and subsequent overtreatment are discussed, with examples, and with relevant literature references. I also suggest that overdiagnosis (if associated with large volume and speed of working) can in turn lead to burnout in doctors. It is hoped that this will generate debate among the audience and we can collectively discuss strategies to address this.

A case is made for a systems approach involving an open and kind culture, early identificaton of doctors with problems, easy access to help and support for those affected including mentoring, coaching, supervision and re-training if required. It is also important to work closely with patient and carer representatives and collect data linking physician and organisational health to clinical practice.

Nurturing those who care can ensure that they can then care in a compassionate and efficient manner, thus ensuring good outcomes for patients, staff and organisations.

Objectives to understand the correlation between physican burnout and overdiagnosis and over treatment

to understand the mechanisms by which it can occur

to discuss ways of addressing this issue and redressing the balance in diagnosis.

Method Literature review

Anonimised and hypothetical case scenarios

Reflection on a system approach

Group discussion

Results At the end of the session I hope there will be increased understanding of the link between physician burnout and overdiagnosis and how we can individually and collectively play a role in resolving this.

Conclusions Burnout among caregivers is an important mechanism by which overdiagnosis can take place.

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