Lifestyle and Burnout: A Bad Marriage

Carol Peckham

|Disclosures|March 27, 2013

Home Life and Burnout

It comes as no surprise that when asked to score their happiness at work from 1 (very unhappy) to 7 (very happy), burned-out physicians who responded to the Medscape survey gave a very low score (average of 3.5) compared with those who were not burned out (5.4). When asked about happiness at home, burned-out physicians gave a much higher rating (average of 5.5) but it was still lower than that of their non-burned-out peers (5.7). The happiest physicians at home were the non-burned-out nephrologists (5.9), dermatologists (5.9), orthopedists (5.8), emergency medicine physicians (5.8), and pediatricians (5.8). The 5 least happy at home were the burned-out HIV/ID physicians (4.7), intensivists (4.8), cardiologists (4.8), gastroenterologists (4.8), and psychiatrists (4.9). See Figure 4. There did not seem to be any correlation between a specialty's happiness status and its burnout severity ranking.

Figure 4. Physician rating of happiness at home (1 = very unhappy; 7 = very happy).

Although no strong evidence exists on whether home life is a major contributing cause of burnout, a recent study on surgeons found that those with conflicts between work and home were more likely to have burnout (36.9% vs 17.1%; P < .001).[24] In the Archives of Internal Medicine survey on burnout,[1] physicians were asked about work-life balance; those practicing preventive medicine, dermatology, and general pediatrics had the highest satisfaction ratings, whereas general surgery and its subspecialties and ob/gyns had the lowest. When looking at Medscape survey responses from these specialties, burned-out dermatologists and pediatricians rated themselves at the mid to lower end of the severity scale and also were among the happiest at home. Burned-out surgeons and ob/gyn respondents were on the higher end of the burnout severity score, but they were also in the top half of the "happiness at home" scores.

Marriage and Children

All physicians, burned out or not, who responded to the survey had a high rate of marriage or life with a domestic partner, but the rate for the burned-out group (82%) was slightly lower than that for their non-stressed peers (87%). This percentage proportion did not differ much among all specialties. There was also a slight association between having more children and a lower rate of burnout, with 35% of burned-out physicians having 1 child or no children compared with 27% of non-burned-out peers. A third of all physicians had 3 or more children (30% of burned-out physicians vs 35% of their less stressed colleagues). The idea that having children mitigates rather than increases the risk for burnout is supported by some studies.[25,26]

Pastimes, Vacations, and the Burnout Effect

According to a 2009 survey from the U.S. Travel Association, activities with the greatest interest among US adults are, in order of popularity, visiting friends and relatives, sightseeing, going to beaches, visiting museums, going to national or state parks, going on cruises, visiting theme parks, traveling to cities, and visiting mountain areas.[27] Physicians' pastime and vacation interests didn't differ much from their patients'. Spending time with family was the favorite pastime of all physicians, and foreign travel and visiting beaches were their favorite vacations.

Favorite pastimes. Percentages were nearly identical for all pastimes listed in the survey, with spending time with family being the favorite (about 86% of all physicians, burned out or not) (Figure 5). Exercise was next, followed by travel; the no-burnout group favored travel a bit more than the stressed group (68% vs 64%). Physicians as a group tend to like reading (62%), cultural events (50%), and food and wine (44%) more than the outdoor sports golf (12%) and hunting or fishing (9%). There were some differences within specialties between the burnout and no-burnout groups, but general preferences were the same.

Figure 5. Physicians' favorite pastimes.

Favorite vacations. Physicians like the same vacations, with the most popular being foreign travel (53%) and beach vacations (51%). See Figure 6. Although burned-out and non-burned-out physicians matched up closely for all types of vacations, the burned-out group slightly preferred beach vacations (53% vs 49%) and had slightly less interest in foreign travel (50% vs 55%). There was also a slight preference by burned-out physicians for adventure vacations, winter sports, and camping and hiking, perhaps because of a greater need to burn off stress.

Figure 6. Physicians' favorite vacation spots.

Amount of vacation time. How much time physicians spent taking those vacations and enjoying their pastimes differed between those who were burned out and those who weren't. Nearly 40% of all burned-out physicians take 2 weeks or less of vacation a year compared with 25% of their less stressed peers. And only 17% of burned-out physicians take 4 or more weeks compared with 26% of their peers. Taking fewer vacation days in the burnout group was consistent across all specialties. There was very little difference between burned-out physicians and their nonstressed peers in their choices of favorite pastimes or vacations. The primary disparity was in the time they had to enjoy them.

Whether taking fewer vacation days produced the stress or the stress was caused by too much time at work cannot be determined from this survey. An interesting study covered by Medscape Medical News[28] found that 1 hour of facilitated peer support every other week during working hours was more beneficial than taking that time off. Sessions were designed to identify and promote personal and professional satisfaction and foster a sense of community, exploring topics such as work-life balance, medical mistakes, and resiliency. The lead investigator observed that "a small amount of protected time during the workday did result in improved meaning from work and reduction in burnout. This was true in both arms of the study, but the effects were larger in the facilitated small group arm."

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  1. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172:1377-1385. Accessed February 7, 2013.

  2. Melville NA. Why are MDs burning out in record numbers? Medscape Medical News. November 27, 2012. Accessed March 13, 2013.

  3. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136:358-367. Abstract

  4. West CP, Huschka MM, Novotny PJ, et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296:1071-1078. Abstract

  5. Firth-Cozens J, Greenhalgh J. Doctors' perceptions of the links between stress and lowered clinical care. Soc Sci Med. 1997;44:1017-1022. Abstract

  6. Gold KJ, Sen A, Schwenk TL. Details on suicide among US physicians: data from the National Violent Death Reporting System. Gen Hosp Psychiatry. 2013;35:45-49. Accessed February 8, 2013.

  7. Schernhammer ES, Colditz GA. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatry. 2004;161:2295-2302. Abstract

  8. CDC. Behavioral Risk Factor Surveillance System. Prevalence and trends data. Physical activity - 2011 Accessed February 9, 2011.

  9. CDC. Health, United States, 2011; with special feature on socioeconomic status and health. US Department of Health and Human Services. National Center for Health Statistics. Accessed March 18, 2013

  10. CDC. Behavioral Risk Factor Surveillance System. Prevalence and trends data. Overweight and obesity (BMI) -- 2011 weight classification by body mass index (BMI). Accessed February 9, 2011

  11. Buss J. Associations between obesity and stress and shift work among nurses. Workplace Health Saf. 2012;60:453-458.

  12. Nevanperä NJ, Hopsu L, Kuosma E, Ukkola O, Uitti J, Laitinen JH. Occupational burnout, eating behavior, and weight among working women Am J Clin Nutr. 2012;95:934-943.

  13. Nyberg ST, Heikkilä K, Fransson EI, et al. Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies. J Intern Med. 2012;272:65-73. Abstract

  14. Hochberg MS, Berman RS, Kalet AL, Zabar SR, Gillespie C, Pachter HL. The stress of residency: recognizing the signs of depression and suicide in you and your fellow residents. Am J Surg. 2013;205:141-146. Abstract

  15. Riboldi L, Bordini L, Ferrario MM. Fitness for work in health care workers: state of the art and possible operational recommendations for its formulation and management in relationship to alcohol and drug addiction. Med Lav. 2012;103:203-211. Abstract

  16. Oreskovich MR, Kaups KL, Balch CM, et al. Prevalence of alcohol use disorders among American surgeons. Arch Surg. 2012;147:168-174. Abstract

  17. CDC. Behavioral Risk Factor Surveillance System. Prevalence and trends data. Tobacco use - 2011. Adults who are current smokers. Accessed February 9, 2011.

  18. Newport F. U.S. drinking rate edges up slightly to 25-year high. Gallup Wellbeing. July 30, 2010. Accessed February 4, 2012.

  19. CDC. Behavioral Risk Factor Surveillance System. Prevalence and trends data. Alcohol consumption - 2011. Accessed February 4, 2012.

  20. Figley CR. Compassion fatigue: psychotherapists' chronic lack of self care. J Clin Psychol. 2002;58:1433-1441. Abstract

  21. Fetter KL. We grieve too: one inpatient oncology unit's interventions for recognizing and combating compassion fatigue. Clin J Oncol Nurs. 2012;16:559-561. Accessed March 13, 2013.

  22. Bilazarian S. The very serious issue of physician burnout. Medscape Cardiology. November 29, 2012. Accessed March 14, 2013.

  23. McMurray JE, Linzer M, Konrad TR, Douglas J, Shugerman R, Nelson K. The work lives of women physicians: results from the Physician Work Life Study. The SGIM Career Satisfaction Study Group. J Gen Intern Med. 2000;15:372-380. Accessed March 13, 2013.

  24. Dyrbye LN, Freischlag J, Kaups KL, et al. Work-home conflicts have a substantial impact on career decisions that affect the adequacy of the surgical workforce. Arch Surg. 2012;147:933-939. Abstract

  25. Ducker D. Research on women physicians with multiple roles: a feminist perspective. J Am Med Womens Assoc. 1994;49:78-84. Abstract

  26. Asch DA, Jedrziewski MK, Christakis NA. Response rate to mail surveys published in medical journals. J Clin Epidemiol. 1997;50:1129-1136. Abstract

  27. U.S. Travel Association. Travel facts and statistics. Accessed February 8, 2012.

  28. Johnson K. Peer support trumps time off in preventing MD burnout. Medscape Medical News. November 6, 2012. Accessed March 15, 2013.

  29. Centor RM, Morrow RW, Poses RM, et al. Doc burnout -- worse than other workers'. Medscape Family Medicine. November 13, 2012. Accessed March 15, 2013.

  30. Pew Forum on Religion & Public Life/U.S. Religious Landscape Survey. February 2008. Accessed February 13, 2011.

  31. Clearfield E, Batalova J. Foreign-born health-care workers in the United States. Migration Policy Institute. February 2007. Accessed February 4, 2012.

  32. The Physicians Foundation. A survey of America's physicians: practice patterns and perspectives. September 2012. Accessed November 16, 2012.

  33. Vicentic S, Gasic MJ, Milovanovic A, et al. Burnout, quality of life and emotional profile in general practitioners and psychiatrists. Work. 2013 Jan 2. [Epub ahead of print]

  34. Cooke GP, Doust JA, Steele MC. A survey of resilience, burnout, and tolerance of uncertainty in Australian general practice registrars. BMC Med Educ. 2013;13:2. doi: 10.1186/1472-6920-13-2.

Authors and Disclosures


Carol Peckham

Director of Editorial Development, Medscape


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