ICD-11 carries about 55,000 codes for injuries, diseases and causes of death, including several new codes and updates. Medical billing and coding service providers are aware that their teams will need extensive training and practice to help healthcare organizations transition smoothly to ICD-11.

The World Health Organization (WHO) has now listed workplace burnout as an “occupational phenomenon” in ICD-11 under “problems relating to employment or unemployment”. Codenamed “QD85”, burn-out appears in the section on “problems associated with employment or unemployment”. While burnout was listed in ICD-10 (Z73.0) in the same category as in ICD-11, its definition has been changed.

 Burnout – New Definition in ICD-11

WHO has clarified that “burnout” is an “occupational phenomenon” that could lead someone to seek care and that it is not a medical condition. The new ICD-11 definition of burn-out is: “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed”. According to the new definition, there are three specific signs of workplace burnout:

  • Feelings of energy depletion or exhaustion
  • Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job
  • Reduced professional efficacy

 Symptoms and Causes of Job Burnout

Burn-out at work has become an increasingly common problem. The possible causes of work-related burnout are being permanently overworked or under-challenged, being under time pressure, multitasking, or having conflicts with colleagues. According to Mayo Clinic, the signs of job burnout include:

  • Becoming cynical or critical at work
  • Difficulty getting to work and trouble getting started
  • Becoming irritable or impatient with co-workers, customers or clients
  • Lack of the energy to be consistently productive
  • Trouble concentrating
  • No satisfaction from personal achievements
  • Feeling disillusioned about the job
  • Using food, drugs or alcohol to pep up mood or to block feelings
  • Change in sleep habits
  • Unexplained headaches, stomach or bowel problems, or other physical complaints

Possible causes of job burnout include lack of control, unclear job expectations, job stress, unfair treatment, unreasonable deadlines, work that is either monotonous or chaotic, lack of support from managers, and work-life imbalance. Burnout needs to be distinguished from stress and depression, though all of these conditions may have some similar symptoms. Physicians need to consider all possible causes to diagnose and treat burn-out.

Reports indicate that risk of occupational burnout is high among physicians, lawyers, IT professionals, and emergency workers like police, paramedics, and nurses. Burnout among physicians has gained significant attention because of the negative impact it has on patient care and medical personnel.

 Survey: Burnout among Physicians a Pervasive Issue

Physicians are exposed to a high level of stress at work which can lead to exhaustion, psychological, and/or physical distress – and burnout. A new Medscape survey revealed that 44% of physicians meet the criteria for burnout, up from 42% in last year’s report. The respondents gave the reasons for burnout as:

  • 59% – too many administrative tasks
  • 34% – spending too much time at work (34%) and,
  • (32%) – increased computerization of practice, e.g., use of electronic health records (EHRs)

By specialty, the survey found that urology had the highest proportion of burned-out physicians with 54%, followed by neurologists (53%). Burn-out was the lowest among those in public health and preventive medicine (28%).

Of physicians reporting burnout or depression, 64% said they will not seek help and have not done so in the past; only 16% said they are seeking help or plan to. Physicians in medical specialties who are most likely to seek help were:

  • Psychiatry: 45 percent
  • Public health and preventive medicine: 45 percent
  • Obstetrics and gynecology: 37 percent
  • Pediatrics: 36 percent
  • Pathology: 34 percent

Urology, Nephrology, General surgery, Rheumatology and Allergy and Immunology were the medical specialties least likely to seek professional help for physician burnout. Reasons given for not seeking help included: “symptoms were not severe enough”, “too busy” and “do not want to risk disclosure”.

The American Medical Association (AMA) has various policies in place to reduce physician burnout and promote a healthier practice environment for physicians. The AMA is continuing to focus on issues leading to physician burnout-including time constraints, technology and regulations-to better understand the challenges facing physicians. The AMA and offer guidance and solutions to promote physician well-being and satisfaction. The AMA’s STEPS Forward™ open-access platform offers innovative strategies to help physicians and their staff to work smarter and succeed in the new health care environment.

Medical billing outsourcing companies also have an important role in helping physicians and their staffs avoid stress and burnout. Outsourcing medical billing saves time spent preparing claims, and communicating with third-party payers. Reliable companies offer the services of billing and coding experts who stay up-to-date with changes in codes and federal and state laws affecting payments. With an experienced service provider handling their claims and collections, physicians can minimize risk of billing errors and increase revenue. Outsourcing would ensure more time to spend with patients as well as networking and leisure activities.