The High Cost Of Health Care Burnout

This article originally appeared in InsuranceNewsNet Magazine

Perhaps no one has felt more pandemic-related pressure than doctors. After a year of widespread sickness and suffering as well as struggling to find enough personal protective equipment and lifesaving gear to do their jobs, medical workers are dealing with residual trauma that could lead to a significant risk of burnout. Studies from 2020 support this outcome.

A September 2020 study from a group of U.S. and Swedish researchers indicated a higher-than-normal level of burnout for doctors during the COVID-19 pandemic, as compared with other years. The study included 2,707 professionals from more than 60 countries and found that 51.4% of providers from 33 countries were experiencing burnout. Here in the U.S., a 2020 report by the Society of Critical Care Medicine surveyed 9,492 intensive care unit clinicians and found that median levels of self-reported stress increased from 3 to 8 (on a 0 to 10 scale) as the pandemic unfolded.

According to The American Journal of Medicine, research regarding doctor burnout is variable due to a lack of agreed-upon terminology. However, it is generally thought to hover between 40% and 50% of doctors during an average year. It is also thought to be most prevalent among doctors ages 45 to 54 — an age of peak income and productivity — and to regularly transition into major depression, substance abuse and even suicide. In fact, burnout-related depression appears to be more common for doctors than for other types of professionals. This statistic has only gotten worse with the pandemic.

Burnout can lead to a mental health disorder or a substance abuse problem that can impact a doctor’s ability to work. As a result, it is important for benefits brokers and advisors to discuss disability insurance with their doctor clients. If pandemic-related stress were to lead to severe emotional anguish that disabled the doctor on a short- or long-term basis, would the doctor’s existing disability insurance policy provide sufficient income replacement during recovery? Would it provide a benefit payout at all? The critical role for benefits brokers and advisors is to become a trusted counselor, helping their clients secure benefits that work in our new world.

Many disability insurance policies are not good enough for doctors.

Doctors have high-income levels, usually comprising multiple income sources, and some own practices or manage heavy debt from student loans. Like many other professionals, their financial solvency relies on their ability to work. Unlike many other professionals, losing the ability to work affects more than just their capacity to support themselves and their families; it sometimes affects the solvency of a medical practice or the doctor’s ability to meet their loan repayment obligations.

Doctors are also unique in that they regularly specialize in a particular area of medicine that is razor-thin in its definition. Examples include broader specialties such as anesthesiology, neurology, emergency medicine and radiation oncology, and more specific sub-specialties such as neuroradiology, medical toxicology, congenital cardiac surgery and hematology.

Doctors need disability insurance that uses a narrow and specific definition of disability. Under this type of definition, a claimant’s CPT/CDT-coded procedures determine disability. If the claimant’s disability prevents the claimant from performing even one of their regularly performed CPT-coded procedures, they are considered totally disabled. Individual disability insurance policies and certain IDI-like group long-term disability policies provide this specificity level.

Beyond this important policy definition, mental and nervous and drug and alcohol (MNDA) coverage must be part of the disability insurance conversation — even in non-pandemic years, when burnout is already high.

Doctors benefit most from disability policies that offer:

1] Solid MNDA benefits. Some long-term disability policies will not cover preexisting conditions, such as major depression or anxiety disorders, and many MNDA disabilities can be recurring in nature.

2] No lifetime max on benefits. Many long-term disability policies cap MNDA benefits at 24 months, which is insufficient for the field of medicine and its higher levels of stress.

3] “Per occurrence” coverage. Policies with this specific language can pay benefits if the doctor suffers a relapse or if the disability caused by burnout manifests differently.

Some long-term disability policies may also require stringent proof of a disability in order to start paying out on the claim. If an insurer requires examinations or rigorous interviews to pay on an MNDA-related incident, doctors can face an undesired compounding of additional stress and pressure.

Make sure your doctor clients are financially prepared for burnout.

COVID-19 has opened many people’s eyes to the importance of coverage for all types of disabilities, both physical and mental. However, overworked doctors may have neglected to review their plans to make sure their expectations for policy payouts align with their contracts’ reality.

Questions brokers and advisors should ask clients during the pandemic and beyond to ensure adequate coverage for burnout-related disabilities include:

» Do all of their disability insurance policies offer MNDA coverage?

» Are the coverage amounts high enough to replace all income and cover any business expenses or student loans?

» Will the policies pay benefits on a relapse under the MNDA provisions? In what time frame?

» Will the policies cover all possible mental and physical conditions that could be attributed to burnout and extreme work stress?

» Are there any preexisting condition exclusions that may affect their ability to collect benefits if they become disabled due to burnout?

Benefits advisors can earn their clients’ trust by working on grasping the realities of doctors’ day-to-day lives, their unique risks, and how much coverage they need. Consider this: The American Journal of Medicine cites specific concerns about burnout rates for a number of doctors in certain fields. Their list includes family physicians, emergency room physicians, psychiatrists, anesthesiologists, cardiologists, radiologists, general internists, dermatologists, oncologists, general surgeons, gastroenterologists, trauma surgeons, obstetrician-gynecologists, and physiatrists.

Until doctors become more comfortable seeking early treatment without the fear of stigmas or professional repercussions, and until their workloads decrease to the point where they can take time to care for themselves, burnout will continue to be a risk factor for disability in the health care industry. Make sure your clients are covered through comprehensive disability plans you know are tailored to their specific needs.