Physician Burnout: It Just Keeps Getting Worse

Carol Peckham

|Disclosures|January 26, 2015
 

Burnout and Happiness in Physicians: 2013 vs 2015

A national survey published in the Archives of Internal Medicine in 2012 reported that US physicians suffer more burnout than other American workers.[1] This year, in the Medscape Physician Lifestyle Report, 46% of all physicians responded that they had burnout, which is a substantial increase since the Medscape 2013 Lifestyle Report, in which burnout was reported in slightly under 40% of respondents. Burnout is commonly defined as loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. There have been questions about the use of these criteria, however. Some studies have suggested that a low sense of personal accomplishment is not associated with burnout, at least in men.[2,3] In other research, simply including the statements "I feel burned out from my work" and "I have become more callous toward people since I took this job" appears to be a valid method for measuring burnout.[4,5] Given the uncertainty in defining and measuring burnout, the criteria used in the Medscape survey to assess burnout in our physician members provide useful information on the current state of physician morale, which, unfortunately, is low.

The Most and Least Burned-Out Physicians

An editorial published in the Journal of General Internal Medicine reported burnout rates ranging from 30% to 65% across specialties, with the highest rates incurred by physicians at the front line of care, such as emergency medicine and primary care.[6] The 2015 Medscape survey results reflect this same pattern, with the highest burnout rates found in critical care (53%) and emergency medicine (52%), and with half of all family physicians, internists, and general surgeons reporting burnout. Of even more concern, among internists and family physicians who responded to the Medscape survey, burnout rates rose from about 43% in 2013 to 50% in both groups, an absolute increase of 7% but a 16% rise in incidence in just 2 years. In last year's Medscape Physician Compensation Report, family physicians and internists were two of the specialties most likely to say they would choose medicine again—but also two of the specialties most likely to say they would not choose their own specialty again.

Other research has shown that the prevalence of burnout in primary care physicians (PCPs) has increased over the previous decade not only in the United States but in Europe as well.[3,7] The least burned-out physicians according to our survey are dermatologists (37%), psychiatrists (38%), and pathologists (39%) (Figure 1).

Figure 1.

Percentage of burned-out physicians by specialty.

 
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References

  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. http://archinte.jamanetwork.com/article.aspx?articleid=1351351 Accessed December 1, 2014.

  2. Ludwig DS, Kabat-Zinn J. Mindfulness in medicine. JAMA. 2008;300:1350-1352. Abstract

  3. Houkes I, Winants Y, Twellaar M, Verdonk P. Development of burnout over time and the causal order of the three dimensions of burnout among male and female GPs. A three-wave panel study. BMC Public Health. 2011;11:240. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101180/ Accessed December 3, 2014.

  4. West CP, Dyrbye LN, Satele DV, Sloan JA, Shanafelt TD. Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. J Gen Intern Med. 2012;27:1445-1452. http://link.springer.com/article/10.1007%2Fs11606-012-2015-7 Accessed December 10, 2014.

  5. Dolan ED1, Mohr D, Lempa M, Joos S, Fihn SD, Nelson KM, Helfrich CD. Using a single item to measure burnout in primary care staff: a psychometric evaluation. J Gen Intern Med. 2014 Dec 2. [Epub ahead of print]

  6. Linzer M, Levine R, Meltzer D, Poplau S, Warde C, West CP. 10 bold steps to prevent burnout in general internal medicine. J Gen Intern Med. 2014;29:18-20. http://link.springer.com/article/10.1007/s11606-013-2597-8/fulltext.html Accessed December 1, 2014.

  7. Twellaar M, Winants Y, Houkes I. How healthy are Dutch general practitioners? Self-reported (mental) health among Dutch general practitioners. Eur J Gen Pract. 2008;14:4-9. Abstract

  8. Shanafelt T, Dyrbye L. Oncologist burnout: causes, consequences, and responses. J Clin Oncol. 2012;30:1235-1241. Abstract

  9. Hampton T. Experts address risk of physician suicide. JAMA. 2005;294:1189-1191. Abstract

  10. 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. http://download.journals.elsevierhealth.com/pdfs/journals/0163-8343/PIIS016383431200268X.pdf Accessed January 20, 2015.

  11. Dyrbye LN, Thomas MR, Massie FS, et al. Burnout and suicidal Ideation among U.S. Medical Students. Ann Intern Med. 2008;149:334-341. Abstract

  12. Jensen PM, Trollope-Kumar K. Building physician resilience. Can Fam Physician. 2008;54:722-729. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2377221/#b19-0540722 Accessed December 9, 2014.

  13. American Medical Association. Regulatory Nightmare Threatens Care for America's Seniors. October 14, 2014. http://www.ama-assn.org/ama/pub/news/news/2014/2014-10-21-regulatory-nightmare-threatens-seniors.page Accessed January 14, 2015.

  14. Keeton K, Fenner DE, Johnson TR, Hayward RA. Predictors of physician career satisfaction, work-life balance, and burnout. Obstet Gynecol. 2007;109:949-955. Abstract

  15. 2014 Survey of America's Physicians. The Physicians Foundation. September 2014. http://www.physiciansfoundation.org/uploads/default
    /2014_Physicians_Foundation_Biennial_Physician_Survey_Report.pdf
    Accessed December 9, 2014.

  16. Brooks M. Less money, more rules for US physicians in 2015. Medscape Medical News. January 2, 2015. http://www.medscape.com/viewarticle/837493 Accessed January 14, 2015.

  17. Lowes R. EHR meaningful use penalty will hit 257,000 clinicians in 2015. Medscape Medical News. December 17, 2014. http://www.medscape.com/viewarticle/836824 Accessed January 20, 2015.

  18. Kane L, Chesanow N. Medscape EHR Report 2014. Medscape. July 15, 2014. http://www.medscape.com/features/slideshow/public/ehr2014#24 Accessed January 16, 2015.

  19. Lowes R. Residents Are flush with job offers and career regrets. Medscape Medical News. January 13, 2015. http://www.medscape.com/viewarticle/838082 Accessed January 20, 2015.

  20. Merritt Hawkins. 2011 Survey of Final-Year Medical Residents. 2011 http://www.merritthawkins.com/uploadedFiles/MerrittHawkings/Surveys/mha2011residentsurvPDF.pdf Accessed January 14, 2015.

  21. Newport F. Majority still says religion can answer today's problems. 2014. Gallup. http://www.gallup.com/poll/171998/majority-says-religion-answer-today-problems.aspx Accessed December 9, 2014.

  22. Doolittle BR, Windish DM, Seelig CB. Burnout, coping, and spirituality among internal medicine resident physicians. J Grad Med Educ. 2013;5:257-261. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693690/ Accessed December 10, 2014.

  23. Wachholtz A, Rogoff M. The relationship between spirituality and burnout among medical students. J Contemp Med Educ. 2013;1:83-91.

  24. Yi M, Luckhaupt SE, Mrus JM, et al. Religion, spirituality, and depressive symptoms in primary care house officers. Ambul Pediatr. 2006;6:84-90. Abstract

  25. Frank E, Carrera J, Dharamsi S. Political self-characterization of U.S. medical students. J Gen Intern Med. 2007;22:514-527. Abstract

  26. Dugan A. Fewer Americans Identify as Economic Conservatives in 2013. Gallup. http://www.gallup.com/poll/162746/fewer-americans-identify-economic-conservatives-2013.aspx Accessed January 20, 2015.

  27. Johnston K. Nearly 1 in 4 workers go without paid time out. August 14, 2014. The Boston Globe. http://www.bostonglobe.com/business/2014/08/13/one-few-countries-that-doesn-mandate-paid-vacation-time/eqodEqumohPyca5kt6hrZO/story.html Accessed December 9, 2014.

  28. Oberg E, Frank E. Physicians' health practices strongly influence patient health practices. J R Coll Physicians Edinb. 2009;39:290-291. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3058599/ Accessed December 9, 2014.

  29. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311:806-814. Abstract

  30. Helfand BK, Mukamal KJ. Healthcare and lifestyle practices of healthcare workers: do healthcare workers practice what they preach? JAMA Intern Med. 2013;173:242-244.

  31. Centers for Disease Control and Prevention. Facts about physical activity. http://www.cdc.gov/physicalactivity/data/facts.html Accessed December 9, 2014.

  32. Centers for Disease Control and Prevention. How much physical activity do you need? August 2, 2014. http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html Accessed December 9, 2014.

  33. Voltmer E, Spahn C. Social support and physicians' health. Z Psychosom Med Psychother. 2009;55:51-69. Abstract

  34. Barnett RC, Gareis KC, Brennan RT. Fit as a mediator of the relationship between work hours and burnout. J Occup Health Psychol. 1999;4:307-317. Abstract

  35. Dyrbye LN, Shanafelt TD, Balch CM, Satele D, Sloan J, Freischlag J. Relationship between work-home conflicts and burnout among American surgeons: a comparison by sex. Arch Surg. 2011;146:211-217. Abstract

  36. Whitley TW, Allison EJ Jr, Gallery ME, et al. Work-related stress and depression among practicing emergency physicians: an international study. Ann Emerg Med. 1994;23:1068-1071. Abstract

  37. Ruotsalainen JH1, Verbeek JH, Mariné A, Serra C. Preventing occupational stress in healthcare workers. Cochrane Database Syst Rev. 2014 13;11:CD002892. [Epub ahead of print] Abstract

  38. Fortney L, Luchterhand C, Zakletskaia L, Zgierska A, Rakel D. Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: a pilot study. Ann Fam Med. 2013;11:412-420. http://www.annfammed.org/content/11/5/412.long Accessed December 9, 2014.

  39. Krasner MS, Epstein RM, Beckman H, et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009;302:1284-1293. Abstract

  40. Galantino ML, Baime M, Maguire M, et al. Association of psychological and physiological measures of stress in health-care professionals during an 8-week mindfulness meditation program: mindfulness in practice. Stress Health. 2005;21:255-261.

  41. Shapiro SL, Astin JA, Bishop SR, et al. Mindfulness-based stress reduction for health care professionals: results from a randomized trial. Int J Stress Manag. 2005;12:164-176.

  42. Regehr C1, Glancy D, Pitts A, LeBlanc VR. Interventions to reduce the consequences of stress in physicians: a review and meta-analysis. J Nerv Ment Dis. 2014;202:353-359. Abstract

  43. Keeton K, Fenner DE, Johnson TR, Hayward RA. Predictors of physician career satisfaction, work-life balance, and burnout. Obstet Gynecol. 2007;109:949-955. Abstract

  44. Tucker P, Bejerot E, Kecklund G, Aronsson G, Akerstedt T. The impact of work time control on physicians' sleep and well-being. Appl Ergon. 2015;47:109-116. Abstract

Authors and Disclosures

Author

Carol Peckham

Director, Editorial Services, Art Science Code LLC, New York, New York

Disclosure: Carol Peckham has disclosed no relevant financial relationships.

Figure 1.

Percentage of burned-out physicians by specialty.

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