In a major survey of US physicians by the Physicians Foundation, in response to how they would rate the professional morale of other physicians they knew, 80.4% said that it would be either somewhat or very negative, and when asked about their own morale, 72.8% responded in the negative. However, when asked how they felt 2 years earlier, 66.2% remembered being positive about their profession. (Of course, there is always the human tendency to romanticize the past, so these reports should be taken with a grain of salt.) Nevertheless, the percentages are striking and might suggest deep discouragement with the present healthcare environment. It should be noted, however, that although almost 58% said that they would not recommend a career in medicine to young people, 66.5% still would choose medicine if they were starting all over again.
The authors of the Archives survey summed up the very challenging issues of burnout, which were also reflected in the Medscape survey:
"Collectively, the findings indicate that (1) the prevalence of burnout among US physicians is at an alarming level, (2) physicians in specialties at the front line of care access (emergency medicine, general internal medicine, and family medicine) are at greatest risk, (3) physicians work longer hours and have greater struggles with work-life integration than other US workers, and (4) after adjusting for hours worked per week, higher levels of education and professional degrees seem to reduce the risk for burnout in fields outside of medicine, whereas a degree in medicine (MD or DO) increases the risk. These results suggest that the experience of burnout among physicians does not simply mirror larger societal trends."
Although many studies certainly have suggested that individual characteristics can increase or reduce the risk for experiencing burnout,[33,34] in his Medscape interview, Dr. Paul Griner offered this advice for dealing with institutional burnout:
"Physicians should participate actively in health reforms that return a greater level of control to their patients and themselves. Embracing the concept of team care is important. Moving from a philosophy of 'I am responsible' or 'I am in charge" to 'We are responsible' or 'We are in charge' is an important step. Supporting the concept of payment for quality instead of 'the more you do, the more you get paid' is an equally important step."
And, finally, in the Medscape Primary Roundtable on burnout interventions, Roy Poses, MD, of Brown University, Providence, Rhode Island, made the following observation:
"Although extensive literature suggests that contributors [to burnout] include excessive workload, loss of autonomy, inefficiency due to excessive administrative burdens, a decline in the sense of meaning that physicians derive from work, and difficulty integrating personal and professional life, few interventions have been tested. Most of the available literature focuses on individual interventions centered on stress reduction training rather than organizational interventions designed to address the system factors that result in high burnout rates...Most interventions meant to improve burnout have treated it like a psychiatric illness, not a rational response to a badly led, dysfunctional healthcare system."