Burnout Severity and Its Effects on Physicians
Burnout is serious. Extensive data indicate a relationship between physician burnout and the quality level of care that is provided to patients.[3-5] In addition, burnout affects physicians themselves. Suicide among physicians appears to be more common than in the general population, and according to some studies, job stress plays a greater role in this event for physicians than in the general population and in fact may account for the higher than average rate of suicide among them.[6,7]
In the Medscape survey, when reporting on the severity of their burnout, it was no surprise that specialties with the highest percentage of burned-out members also tended to report greater severity of their burnout (Figure 2). One interesting exception was pathologists, who had the lowest percentage of burnout but ranked second in severity (after ob/gyns).
Figure 2. Severtity of burnout (Scale: 1 = does not interfere with my life; 7 = so severe that I am thinking of leaving medicine altogether)
Physicians were also asked to rate their health on a scale of 1 to 7, where 1 = in poor health and 7 = extremely healthy. The mean score of all physicians surveyed was 5.6, but, to be expected, those who were burned out were less confident about their health (5.3) than their non-burned-out colleagues (5.8), a difference of about 10%.
In his Medscape interview advising physicians on burnout, Dr. Griner said, "To begin with, in order to remain physically and mentally healthy, physicians should follow the advice they give their patients -- eat a healthy diet, exercise, rest, take time with and enjoy their families. At the end of each day, reflect on what went well, who you helped, and what challenging diagnoses you made."
Exercise. The most recent statistics from the Centers for Disease Control and Prevention (CDC) report that only about 25% of US men and 16.2% of women participated in enough aerobic and muscle-strengthening exercises to meet guidelines. (Guidelines for muscle-strengthening exercises require activity at least twice per week, and for aerobic exercises, 150 minutes or more per week.)
Physicians who responded to the Medscape survey do better than their patients; only 5% of non-burned-out physicians and 7% of the burned-out group confessed to no exercise all. More than half of all physicians exercise at least twice a week, although fewer burned-out physicians exercise at that level (55% vs 65% of their non-stressed peers). Looking at the less-exercise group, 46% of the burned-out group exercised once a week at most compared with 34% of their less stressed peers. This difference held throughout most of the specialties.
Weight. According to a CDC report, 35.8% of US men and women were overweight in 2011 and 27.8% were obese. Only 34.5% were normal weight and 1.8% were underweight. Burnout and stress have been associated with overweight,[11-13] and although physicians who reported their BMI in the Medscape survey do better than their patients, it is still a problem even among these professionals, and more so in the high-stress group. Thirty-eight percent of physicians in the burned-out group were overweight and 9% were obese compared with 35% and 5% of the less stressed group, respectively.
Although some studies suggest that physician burnout is associated with a higher rate of substance abuse,[14-16] evidence is limited. This was not borne out in the Medscape survey, where few physicians reported smoking and alcohol use was very moderate in both the burned-out and non-burned-out groups in all specialties.
Smoking. Although the national quit rate has increased over the past few years, according to recent CDC data, 21% of Americans still smoke. Smoking is not a problem among the great majority of physicians, both those who are burned out and those who are not, with only 2% of them being smokers.
Alcohol. As reported in a 2010 Gallup poll, 67% of American adults drink alcohol, a rate that has been "remarkably stable" since this began being tracked in 1939. In the most recent CDC report, 57.1% of US adults had at least 1 drink within the past month, 18.3% of adults are binge drinkers, and 6.6% confess to being heavy drinkers (adult men having more than 2 drinks per day and adult women having more than 1 drink per day). Medscape survey respondents have very moderate drinking habits, and there is no difference between those who are burned out and those who are not. Thirty percent of all physician respondents said that they don't drink at all, and about 52% have less than 1 drink per day.