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Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Events of the past year challenged the happiness, wellness, and lifestyles of many, but especially those in the healthcare field. Whether physicians were on the front lines treating COVID-19 patients, pivoting from in-person to virtual care, or having to shutter their practices, they faced an onslaught of crises while political tensions, social unrest, and environmental concerns probably affected their lives outside of medicine.
In this year's report, Medscape explores how hospitalists are coping with burnout, maintaining personal wellness, and viewing their workplaces and their futures amid the pandemic. More than 12,000 physicians in over 29 specialties responded to our survey.
Nearly 8 out of 10 hospitalists reported that they are internists, with 21% working in family medicine.
(Note: Some totals in this presentation do not equal 100% due to rounding.)
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Hospitalists largely reported being happy outside of work prior to the COVID-19 pandemic affecting everyday life in March 2020. Seventy-six percent said they were somewhat or very happy at that time, similar to the percentage (80%) of their non-hospitalist peers. ("Non-hospitalist" refers to primary care physicians and pediatricians.)
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
As the pandemic has worn on, feelings have shifted, showing signs of strain on the healthcare industry and its doctors. Just over half (52%) of hospitalists say they are now very or somewhat happy outside of work. This is similar to the percentage (57%) of non-hospitalists, whose happiness also declined amid COVID-19.
Alok S. Patel, MD, a pediatric hospitalist and Medscape consultant, says issues ranging from overburdened hospitals to lack of personal protective equipment caused burnout among doctors and suffering among patients.
"These are not issues that simply disappear once you leave the hospital," he says. "Physicians carried all this stress home, every day, during the pandemic."
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
The percentage of hospitalists who said they were either burned out or both burned out and depressed is nearly the same as among all physicians (47% vs 42%).
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Around three quarters (78%) of hospitalist respondents who reported burnout consider it serious enough to have at least a moderate impact on their lives. Six percent find it so severe that they are thinking of leaving medicine altogether, an unexpected outcome after having spent so many years in training to become a physician.
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Half of hospitalists who reported burnout pointed to the growing number of bureaucratic tasks as the leading contributor. This was also the leading factor of non-hospitalist burnout. Other factors contributing to stress for hospitalists include lack of respect from colleagues in the workplace and more time devoted to using EHRs. (Respondents could choose more than one answer.)
"The bureaucracy in hospitals and administrative tasks interrupt physicians' workflow and their ability to directly care for patients," says Patel. "There seems to be more loss of autonomy and hoops to jump in clinical care, as well. Physicians went into medicine to take care of patients, yet the amount of time actually spent in direct patient care seems to be progressively getting smaller."
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Hospitalists' and non-hospitalists' top tactic for dealing with burnout is talking with family and friends. As leading ways to deal with their stress, both physician groups selected a mix of positive strategies, such as exercise, and negative strategies, such as isolation and eating junk food. (Respondents could choose more than one answer.)
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
The majority (71%) of depressed and/or burned-out hospitalists plan to forego professional care for the problem. Close to one-fifth are seeking help now or plan to do so.
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
The top two reasons why hospitalists haven't sought professional help for their burnout and/or depression are because they do not consider their symptoms severe enough and they feel that they could deal with the problem a different way. (Respondents could choose more than one answer.)
Patel says he personally knows several physicians who felt too ashamed to ask for help or report a mental health issue. "The archaic stereotypes that physicians shouldn't be weak is just that — archaic and outdated. Given the overburdened healthcare system and increasing work hours, some physicians aren't able to take time for themselves or their families either, which also adds to mental health distress."
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Fourteen percent of hospitalists who are burned out, depressed, or both said they have had thoughts of suicide.
Alarmingly, our survey showed that 2% of burned-out and/or depressed hospitalists have made suicide attempts, which is similar to the percentage for physicians overall.
Patel would like to see a top-down approach, dismantling the mental health stigma among physicians and encouraging them to be open about any feelings of distress or burnout.
"Administrations need to have sincere, open-ended conversations with physicians about the root causes of mental health issues and burnout rather than try and assuage symptoms with 'pizza parties,' emails about meditation, or coffee cards," he says. "We need a system-wide culture change."
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Work-life balance is the most pressing workplace issue for more than one third (37%) of hospitalists. Seventeen percent of hospitalists noted compensation as a main concern.
"Work-life balance is now a goal to strive for, rather than an expectation, for life as a hospitalist" says Patel. "This is especially true if a hospitalist wants to get promoted at an academic center, is working on research, or serves on another hospital committee. The work follows them home, long after they finish their shifts."
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
About three quarters (79%) of hospitalists have some degree of anxiety about their future because of the COVID-19 pandemic, similar to the percentage for physicians overall. However, The U.S. National Pandemic Emotional Impact Report, a project spearheaded by investigators at the University of North Carolina at Chapel Hill and Harvard Medical School, found that 23% of Americans surveyed had no fear of a bleaker future.
"This speaks to a fundamentally positive attitude toward life, even in a pandemic, and it echoes the research on resilience in physicians," said Michael F. Myers, MD, a specialist in physician health and professor of clinical psychiatry at SUNY Downstate Health Sciences University in Brooklyn, New York. "Physicians who are not paralyzed by anxiety are in a good position to help their patients because they can be hopeful, empathic, and calming."
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Nearly two thirds (62%) of hospitalists say they exercise two or more times per week.
Patel tries to do something movement-related 5-6 days a week, such as martial arts, running outside, or even cycling to the hospital.
In March 2020, the World Health Organization recommended that adults get 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity, or a combination of both. The group noted that this is for people in self-quarantine without any symptoms or diagnosis of acute respiratory illness.
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Twenty-eight percent of hospitalists take 3-4 weeks of vacation each year, whereas nearly half of non-hospitalists take the same amount of time away from work. The percentages for five or more weeks of vacation are similar among hospitalists and non-hospitalists (13% vs 12%).
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Thirty-eight percent of hospitalists are currently trying to lose weight, with a similar percentage (36%) working to maintain their current weight — no easy task during the pandemic.
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
The majority of hospitalists are currently in a committed relationship, with 78% either married or living with a partner. Eighty-five percent of physicians overall report being in such a relationship.
Patel, who is married, says his challenge is to find dedicated, uninterrupted time with his wife, free of email, charts, phones or thinking about his hospital work.
"My colleagues who are single and dating reported, perhaps not surprisingly, that it was very hard to date during the pandemic," he says. "Although, I suspect this problem isn't unique to hospitalists."
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Nearly eight in 10 hospitalists say their marriages are very good or good. Both this year and last, 85% of physicians overall said their marriages were very good or good.
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Among hospitalists who are married or living with a partner, a little less than half are with someone in the medical field. Similarly, among all physicians, 43% have a spouse or partner who works in healthcare.
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
Forty-six percent of hospitalists spend up to 10 hours per week online for personal use. Nearly as many (42%) spend 11 to 20 hours on the internet each week.
Keith L. Martin; Mary Lyn Koval | May 7, 2021 | Contributor Information
A large majority of hospitalists are online for work for up to 10 hours per week. However, we can assume that use of the internet for work will grow with the rise of telemedicine due to the pandemic.
Medscape's Hospitalist Compensation Report explores annual earnings, incentive bonuses, time spent on paperwork and administration, and how physicians feel about their careers.Medscape Features Slideshows, July 2020
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Keith L. Martin
Editorial Director
Medscape Business of Medicine
Mary Lyn Koval
Editorial consultant
Disclosure: Mary Lyn Koval has disclosed no relevant financial relationships.
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