Barriers to Working with Patients Who Misuse Opioids and Physician Burnout: Implications for Medical Education

Abstract

Background

Physicians are on the front lines of the U.S. opioid epidemic, providing care in multiple treatment settings. Very little is known, however, about whether this experience has contributed to physician burnout. This information is critical for guiding efforts to expand the relatively low level of training on opioid misuse currently available in medical education.

Methods

We surveyed 408 board-certified physicians practicing in Ohio about their experiences working with patients who misuse opioids. We also collected quantitative measures of physicians’ burnout and their level of contact with this patient population. We coded and analyzed open-ended responses and calculated a partial correlation between contact and burnout, controlling for relevant factors.

Results

Physicians experienced three primary barriers when working with patients who misuse opioids: inadequate knowledge and training, limited external resources and partnerships in their communities, and an incomplete context for understanding problematic patient behaviors. 70% of physicians experienced negative emotions when working with this patient population and 19% mentioned experiencing burnout specifically. Contact with patients who misuse opioids was significantly and positively associated with burnout scores.

Conclusions

Our findings underscore the need for medical educators to take a proactive approach to equipping physicians with the knowledge, skills, and resources needed to effectively work with patients who misuse opioids.

Keywords:

• Opioid use disorder
• burnout
• stress
• medical education
• stigma
• opioid misuse

Acknowledgements

We wish to acknowledge Lee Ann Williams and the Clinical and Translational Research Unit at Ohio University for assistance with data collection. We also wish to acknowledge the Osteopathic Heritage Foundation who provided internal funding for a career development fellowship on opioid misuse for the senior author.

Declaration of interest

The authors have no conflicts of interest to report.

Ethical approval

This study was approved by the Ohio University Institutional Review Board on 6/3/2020 (19-E-301).

Additional information

Funding

The senior author holds an endowed faculty fellowship in population health science from the Osteopathic Heritage Foundation which supported this research.