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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020
| Contributor Information
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Burnout remains a major challenge for physicians; it affects happiness, personal relationships, career satisfaction, and patient care. This issue has gained major attention in recent years, although many doctors say they have seen little improvement.
In this year's report, Medscape looks at how different generations experience and respond to the pressures they face. We compare millennials (25-39 years old), Generation X (40-54 years old), and baby boomers (55-73 years old). While values, attitudes, and life experiences differ, healthcare's predicaments are universal.
More than 15,000 physicians in over 29 specialties responded to our survey.
(Note: Some totals in this presentation do not equal 100% due to rounding.)
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
This year, 42% of physicians reported that they are burned out, down from 46% 5 years ago. Specialties that have been among the top in burnout over the past 5 years include critical care, emergency medicine, family medicine, internal medicine, neurology, and urology.
Burnout has been described as long-term, unresolvable job-related stress that leads to exhaustion, cynicism, feelings of detachment from one's job responsibilities, and lack of a sense of personal accomplishment.
"The percentage of physicians feeling burned out remains fairly consistent. The leading cause is administrative burden, as driven by the workplace and organizational culture," says Frank John Ninivaggi, MD, a physician at Yale New Haven Hospital and author of Learned Mindfulness: Physician Engagement and MD Wellness.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Generation X physicians report noticeably more burnout than other groups.
"Mid-career is typically the time of highest burnout, which is where Gen Xers are in their career trajectories," says Carol A. Bernstein MD, vice chair for faculty development and well-being, Montefiore Medical Center/Albert Einstein College of Medicine. "In addition, I suspect that group is juggling multiple roles outside of work, including caring for children as well as elderly parents, and working as well as planning for retirement. Role strain and transition periods also increase stress."
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Women have consistently reported higher percentages of burnout than men over the years. In 2015, a greater proportion of women (51%) than men (43%) said they were burned out.
"Harvard Business Review published some pieces on the idea that women take on more work at work," says Halee Fischer-Wright, MD, CEO of the Medical Group Management Association. "They take on more 'non-promotable' work and they carry more of the weight in collaborative work. There are lots of reasons for this, but one is that they tend to care more about the collective, such as the well-being of their colleagues or the success of the business."
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Long hours, overwhelming workload, and lack of support are among the factors pushing many physicians to the bursting point. These top causes of burnout have not changed over the years.
"I have to catch up with charting, even at home. I'm worrying about always being behind. The pressure from my employer about not seeing enough patients is very stressful. There's no work-life balance." -Gastroenterologist
"My quality markers are tied to things I cannot control, ie, patients don't take medication and they get worse." -Endocrinologist
"Increasing EHR data requirements turns us into technicians." -Family physician
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
The challenges in healthcare are generally universal, although one factor that varies by generation is the stress of using an EHR. Only the boomer generation mentioned "increasing computerization of practice (EHRs)" as one of the top three factors contributing to burnout. For millennials, EHR use was second lowest on a list of 10 potential factors, while too many bureaucratic tasks was cited most often by all three groups.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Of the physicians who said they were burned out, baby boomers more often replied that they are severely affected by it. They have gone through major changes in medical practice, such as the trend from self-employment to employment; and from a lifetime of using paper records to the demands for more and more EHR reporting. Gen X physicians also feel more severe impacts from burnout.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Burnout has affected relationships for millennials the most, but it plays a role in relationships for all physicians.
"Burnout makes one frustrated with lots of things in life. It takes a toll on my personal life: stress eating, weight gain, poor sleep, to name just a few things as a result of burnout." -Ob/Gyn
"Because of burnout, I have become estranged from my family, had substance and alcohol abuse, failed relationships, and chronic back pain which adds to my symptoms. No vacation. Being put under a microscope when I want refills of my medications by my doctor." -General surgeon
"Burnout has affected my loving relationship with my spouse (I'm grumpy and exhausted when I finally come home from work). I'm unable to visit friends and family because of work demands." -Anesthesiologist
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Physicians are more likely to use positive coping mechanisms rather than "escape" or self-medicating activities to deal with burnout.
However, Wendy Dean, MD, psychiatrist and cofounder of MoralInjury.healthcare, an organization devoted to building advocacy to end moral injury in the healthcare professions, notes, "Healthcare systems have looked for fixes for physician distress, focusing on wellness (yoga, retreats, and self-care lessons), but finding solutions requires that we address the problem for what it really is: a challenge inherent in the structure of the healthcare industry."
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Sleep is favored by millennials to help ease burnout; Generation X and baby boomers are most likely to exercise or isolate themselves.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
It's a powerful statement: Overall, 49% of physicians in all generations would accept less money in exchange for more free time. "Expectations of what a career as a physician is in the 2020's are changing," says Fischer-Wright. "Physicians recognize that seeing a smaller number of patients may give them more time with patients and the ability to practice medicine at the height of their license, reducing non-clinical hours and enhancing personal satisfaction, which ultimately may decrease burnout and extend their career life."
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
A higher percentage of women physicians would take a salary reduction than would men. That's not surprising, as women typically still spend more time than men on childcare and domestic responsibilities.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Doctors are clearly crying out for more time. Of those who said they would give up salary to gain a better work-life balance, about a third of each generational group would give up from $10,001 to $20,000. More baby boomers than other generations would give up from $20,001 to $50,000, possibly because they're earning more and so the drop is less meaningful, or because they are preparing for a retirement lifestyle.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Solo practice has been declining over the years and now comprises only about 15% of physicians. Still, some say that running one's own practice helps prevent burnout because those physicians are in charge of what they do, how they do it, and how productive they choose to be.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
More physicians (59% overall) are happy (extremely, very, or somewhat) with their work life than are not. That's lower than among professionals overall, however; a recent CNBC poll of professionals showed that 85% were either somewhat or very satisfied with their work life.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
There was little difference among the three groups in regard to being happy/unhappy with their work life, although the millennials had a slight edge on happiness.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Burnout and depression are not the same, although burnout may lead to depression. Similar percentages of each generational group said they were depressed. For each generational group of physicians citing depression, about two thirds considered it "colloquial" depression (feeling down, sad, or blue) while less than one third described it as "clinical" depression (prolonged severe depression not caused by a grief-associated event).
"I feel hopelessness, anger, family and marital strife, a lack of retirement ability, resentment of non-physician business leaders, and increased cynicism. It just shouldn't be that way." -Critical care physician
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
The large majority of physicians who said that they were depressed have never considered suicide. However, about 1% have attempted suicide. These percentages were similar for male and female physicians. Sadly, an estimated 300-400 physicians commit suicide each year.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Of those who said they were depressed, almost a quarter said they had had thoughts of suicide. There was very little difference among the generational groups in this regard.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
A large percentage of depressed physicians have not spoken to anyone about their thoughts of suicide. Baby boomers were more likely to speak to a therapist than to a friend or family member; millennials and Gen Xers were more likely to talk with a friend, colleague, or family member.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Close to half of all generations answered that their depression does not intrude upon their interaction with patients. However, for the other half, depression gets expressed in some way. More than any other group, over one third of millennials who were depressed said they were less motivated to be careful when taking patient notes.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Handling it by themselves is the norm for almost two thirds of all physicians.
"I don't think burnout is a psychiatric problem or my personal problem. I think it is inherent in the present way of healthcare delivery, at least in the US." -Cardiologist
"I think it stems more from my dislike of the current way medicine is practiced as a whole. I don't see the system changing to fit my needs." -Oncologist
"The way I prefer to deal with it is that I have done classes and conferences to address burnout specifically; I practice mindfulness, meditation, and yoga." -Internist
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
A little more than a quarter (28%) of physicians say their workplaces offer stress reduction programs, while half say their workplaces don't. Another 22% overall (higher among millennials) don't know whether such programs are available to them.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Although there is increasing pressure for organizations and hospitals to provide wellness programs for physicians, 42% of respondents overall said they probably would not use them. Many physicians don't believe that such programs are helpful; others don't want to let colleagues at their workplace know they're feeling burned out.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Half of all physicians said their symptoms were not severe enough to seek professional help; others said they could deal with it on their own or were too busy. Respondents could choose more than one answer.
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
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Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
Leslie Kane, MA | January 15, 2020 | Contributor Information
Almost 20,000 physicians in over 30 specialties told us how much they earn, whether they are satisfied with their jobs, and whether their income has gone up or down.Medscape Features Slideshows, April 2019
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Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
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Leslie Kane, MA
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