Physicians are stressed out, with 44 percent reporting they feel burned out and 15 percent reporting they are depressed, according to a recent report from Medscape.
The high rate of burnout and depression in the field also underscores a critical risk: suicide. About one physician commits suicide every day, according to the 2019 report. The profession has the highest suicide rate, with 15 percent reporting they have had thoughts of suicide or attempted it.
Of physicians that reported feeling depressed, 11 percent were colloquially depressed––feeling down or blue––while 4 percent were clinically depressed––defined as prolonged, severe depression.
The survey queried more than 15,000 physicians across more than 29 specialties from July 27 through October 2018 to analyze how physicians wrestled with difficult issues and workplace factors.
Burnout is typically defined as long-term, unresolvable job stress, with feelings of being overwhelmed, cynical, detachment from the job, a lack of personal accomplishment and exhaustion, according to Medscape. Physicians reported a number of factors that contributed to feeling or burnout and depression, revealing that there may not be one quick fix to mitigate the consequences of the physician role.
The top five contributors included:
- Too many bureaucratic tasks (59 percent)
- Spending too many hours at work (34 percent)
- Increasing computerization of practice, EHRs (32 percent)
- Lack of respect from administrators/employers, colleagues or staff (30 percent)
- Insufficient compensation/reimbursement (29 percent)
Long hours had a strong correlation with burnout, with more hours worked contributing to higher reports of burnout. While physicians may be used to working long hours, the increasing use of EHRs and burdensome administrative tasks are compounding the issue, according to the study.
“Burnout is mostly due to lack of sleep because the EHR takes so much time,” one internist said in the survey.
Previous studies have similarly linked EHR use to physician burnout.
Women were more likely to report feeling burned out compared to men, 50 percent to 39 percent, respectively, and multiple factors may explain that gap.
“Women are more likely to admit to psychological problems and seek help, and thus may be more likely to acknowledge burnout than their male counterparts,” Carol Bernstein, MD, psychiatrist at NYU Langone Medical Center, told Medscape. “Second, women generally acknowledge more challenges with work-life balance than do men. Childcare and family responsibilities are disproportionally assumed by women, despite increasing numbers of men who are more involved than in previous generations.”
Across different healthcare settings, office-based solo practices reported the lowest level of burnout, potentially because these physicians have more autonomy than their counterparts within groups and organizations.
Physicians also reported personal impacts from their roles, including relationship struggles.
Another critical effect––less focus on patient care:
- 47 percent said their depression did not affect interactions with patients
- 35 percent they were easily exasperated with patients
- 26 percent were less motivated to take care careful patient notes
- 16 percent expressed frustration in front of patients
- 14 percent made more errors
“I’ve lost enthusiasm for patient care,” one neurologist reported.
To cope with burnout, physicians cited exercise as the top method (48 percent), following by talking with close friends and family (43 percent) and isolating from others (41 percent).
Overwhelmingly, physicians did not seek professional care for help with burnout or depression and did not plan to, as many normalized these feelings. Many said their symptoms were not severe enough for professional help, they could deal with burnout and depression on their own or they were too busy. About half of physicians fell somewhere in between burnout not impacting their lives to it being so severe they considered leaving medicine.
Fortunately, many organizations are taking note of the high rate of burnout and its impacts on physicians, staff and patients, and taking action to reduce stresses of the role across specialties.