The New York Times recently published an op-ed about how healthcare workers are “burned out” from multiple factors, including decreased staffing, pandemic challenges and increased regulatory oversight. This opinion essay minimizes those factors and instead focuses on how the American healthcare system has let us down. 

The United States is the only first-world country that ties healthcare to employment. When the Public Health Emergency (PHE) started in 2020, and so many people lost their jobs, lost their daycare, lost their schools and had to stay home, the employees lost their healthcare. When our SNF employees lost their child care, they stopped working and subsequently lost their health insurance. 

“Demoralization syndrome” is typically seen when a patient enters hospice and is characterized by a feeling of helplessness and loss of purpose in the terminally ill patient. We in healthcare are starting to feel that pain. 

PHE + no health insurance = disaster. How can a person who becomes sick get care for themselves in the face of a Public Health Emergency and without health insurance? One study estimates that over 300,000 deaths in the United States could’ve been prevented if universal healthcare was an option. 

Our health insurance system is for-profit. They collect your premiums for 30 years, then frequently deny payment for services. I know a geriatric patient whose hospital claim was denied for “no prior auth”, to the tune of $50K. Her admitting diagnosis was hypertension at 237/101. But her claim was denied. 

Don’t get me started on the disadvantages of Medicare Advantage. How many hours have we all spent on the phone with private insurers getting prior authorization, appealing denials, doing Peer-to-Peer reviews? All that time could have been spent on doing actual patient care. Healthcare should be a right, not an inequitable privilege only for those who are employed or in the upper/middle class. 

As Americans, we have a strong belief that our healthcare system is the greatest in the world. Dignitaries from across the globe come to us for healthcare, knowing that we are their best chance for a cure and survival. We work toward the greater good, but we know that our efforts are frequently denied. 

As of 2022, 1.7 million people have left healthcare jobs. Many of my own staff didn’t return after the lockdown was eased; they became copywriters, business administrators and home caregivers. The Great Resignation was seen everywhere, but healthcare was hit hardest, during a pandemic, with almost 30% of nurses leaving their jobs. Sixty percent of physicians report burnout. Our hearts are breaking for our patients but also for ourselves. 

How to avoid burnout in your workplace? The syndrome is caused less by the grueling conditions but more by diminishing faith in our systems. We are not going to change the American healthcare insurance quandary today. But we need to go forward in creating and supporting standards that our employees can live with. 

How can you help today? 

  • Build a commitment to the health and safety of your employees. 
  • Review and revise policies that employees can easily access appropriate care for their physical, emotional and mental health challenges.
  • Increase access to high-quality, confidential mental health services. 
  • Combat bias, racism and discrimination in the workplace. 
  • Invest in prevention services for physical and mental health. 

The way to prevent hopelessness is to offer hope. When we see our patients in dire need of care, but their insurance puts the brakes on, we need to make the effort to support further services by offering care, creating a payment system that doesn’t adhere to the arbitrary system of billing codes (CPT) that was invented by the American Medical Association to push for-profit care (another story for another day.) 

While it may not be great for the bottom line, offering care to those who need it but can’t pay will filter back to your employees and show them that their efforts are worthwhile. Burnout among your employees hurts everyone. 

Jean Wendland Porter, PT, CCI, WCC, CKTP, CDP, TWD, is the regional director of therapy operations at Diversified Health Partners in Ohio.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.