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Mary Lyn Koval | February 24, 2023 | Contributor Information
Cardiologists are finding that their happiness level and work-life balance are not springing back easily even as COVID-19's effects on the workplace wane. Many doctors are struggling to find the same level of contentment that they enjoyed before the pandemic, to feel like they are healthy people with enough time for their families.
Meanwhile, the impact of persistent burnout and depression continues to build among cardiologists. Frustration, sadness, and anger are widespread.
Medscape surveyed more than 9100 physicians across more than 29 specialties. Their responses give insights into how choices surrounding their marriages, family relationships, personal habits, and lifestyles influence their happiness. Cardiologists also told poignant stories of how burnout and depression affect them, how these challenges can harm personal and patient relationships, and how they are trying to deal with them.
(Note: Some totals in this presentation do not equal 100% because of rounding.)
Mary Lyn Koval | February 24, 2023 | Contributor Information
Compare cardiologists against other specialists in the percentage who said they were either "very happy" or "happy" with their lives away from work before the COVID-19 pandemic hit. At least 3 in 4 physicians in every specialty felt that happy about their personal lives before the pandemic upended American society.
Mary Lyn Koval | February 24, 2023 | Contributor Information
Cardiologists surveyed by Medscape were about as likely as physicians overall (58%) to describe their lives away from the office as "very happy" or "happy." Physicians in every specialty were substantially less happy with their personal lives than they were pre-pandemic.
Mary Lyn Koval | February 24, 2023 | Contributor Information
In last year's Medscape report, 40% of male cardiologists and 55% of their female counterparts said they felt burned out (either burned out or both burned out and depressed). Whereas male and female cardiologists were more evenly matched in this regard this year, burnout consistently afflicts a greater percentage of female physicians overall than male physicians.
"Studies have shown a clear link between microaggressions — either race- or gender-based — and an increased risk of workplace distress," says Wendy Dean, MD, co-founder of Fixmoralinjury.org. "Whether it's emotional exhaustion (burnout) from constantly having to defend their authority; being overlooked for leadership opportunities; having different expectations of behavior; being interrupted or talked over in meetings; or as betrayal (moral injury) by an organization failing to uphold stated codes of conduct, women's relative disempowerment to men puts them at higher risk of distress."
This year, 36% of physicians overall said they felt burned out, 5% felt depressed, and 18% said both.
Mary Lyn Koval | February 24, 2023 | Contributor Information
The share of burned-out cardiologists who cited strong or severe impacts was similar to that of physician respondents overall (43%). Meanwhile, 22% of physician respondents in general who said they were burned out reported little or no impact.
The largest share of burned-out physicians in general said this year that burnout has a severe impact on their lives. Harvard Business Review noted that there are three types of burnout: (1) Overload, in which you feel forced to work at an unsustainable pace; (2) Underchallenged, where your tasks are boring and monotonous; and (3) Neglect, in which you have no guidance or structure. Overload was mentioned most often by physicians.
Mary Lyn Koval | February 24, 2023 | Contributor Information
In last year's report, the leading factors behind burnout among cardiologists were (1) bureaucratic tasks, (2) lack of peer respect, (3) lack of control or autonomy, (4) increasing computerization of their practice, and (5) too many hours on the job.
EHR documentation continued to frustrate physicians in general. On average, physicians spent 1.84 hours per day beyond work hours completing EHR documentation, according to research published in a JAMA Internal Medicine report. That adds up to 9.2 hours spent each week on work outside of the workday.
Mary Lyn Koval | February 24, 2023 | Contributor Information
The coping mechanisms most frequently used by doctors overall were (1) exercise, (2) talking with family or friends, (3) getting more sleep, and (4) spending time alone.
Physicians overall mostly chose positive coping mechanisms such as exercise and talking with friends, although smaller percentages ate junk food, drank alcohol, or engaged in binge-eating. Some doctors may use a combination of tactics at different times.
Other coping tactics mentioned:
Read books unrelated to medicine; pray; hunt and fish; take a crafting class; binge on Netflix; play video games; internet shopping and surfing; ride my motorcycle; play with my dog; see a therapist.
Mary Lyn Koval | February 24, 2023 | Contributor Information
As with doctors overall, 13% of cardiologists said they have sought professional help outside of the workplace for burnout. Many physicians commented that they feel that they can deal with it themselves and that professionals have nothing to add.
Mary Lyn Koval | February 24, 2023 | Contributor Information
"The impact of COVID on physician burnout will remain for years," says John Whyte, MD, WebMD chief medical officer. "The focus has changed. Now it's all about helping patients catch up on all the care, especially preventive, that they missed. This is causing very busy days and long lines, which frustrates everyone. And COVID taught us more about the social determinants of health; now everyone wants us to measure and do more things in a brief office visit."
Mary Lyn Koval | February 24, 2023 | Contributor Information
In our report last year, 83% of cardiologists who felt depressed described their condition as colloquial and 7% said it was clinical. In results from all physicians this year, 67% said it was colloquial and 24% clinical.
Mary Lyn Koval | February 24, 2023 | Contributor Information
Among physicians overall, as among cardiologists, respondents named job burnout the top factor, but world events played a large role too.
"COVID forced much great global awareness, especially so for doctors who turned to each other in different parts of the world, in different situations, with different resources, for support and medical expertise in order to survive and do their job," says Margaret Calvery, PhD, professor of pediatrics at University of Louisville School of Medicine. "One is constantly made aware of the inequalities in our country and the world, and it can feel hopeless and helpless to create change for such a big problem."
"With all that's going on, I've lost my faith in humanity," added one respondent.
Mary Lyn Koval | February 24, 2023 | Contributor Information
Around half (51%) of all depressed physician respondents insisted their patient interactions are not affected. But 32% of them admitted to showing exasperation and 19% said their patient notes suffered.
Likewise, about half of depressed cardiologists said they are able to put their depression on the back burner when treating patients. Yet, some admitted that they're functioning at less than 100% and may make errors or show exasperation toward patients.
Mary Lyn Koval | February 24, 2023 | Contributor Information
Among doctors in general, family and friends, activities, and hobbies seem to be strong antidotes to help them live a happy life, with each used by at least 2 in 3 respondents. Getting enough sleep was also an important factor for about half of respondents overall.
Mary Lyn Koval | February 24, 2023 | Contributor Information
Contrast these cardiologist responses with those from male physicians overall, 28% of whom described themselves as "very conflicted" or "conflicted," 30% as "somewhat conflicted," and 42% as "not at all conflicted" or "not very conflicted." Among all female doctors, the comparable responses were 49%, 27%, and 24%, respectively.
Substantially greater shares of female cardiologists and of female doctors in general said that they deal with stronger feelings of conflict in trying to balance parenting responsibilities with a highly demanding job.
Adding to the stress, female physicians often have a hard time talking about that conflict with their bosses and turn down career-advancement opportunities, according to a JAMA Network Open article.
Mary Lyn Koval | February 24, 2023 | Contributor Information
Compare the 32% of cardiologists who exercise at least four times each week with the 35% of doctors in general who can say the same. At the other end of the spectrum, 23% of cardiologists work out less than once weekly or never, vs 30% for all physicians.
Of course, cardiologists and other physicians have frantic schedules, but experts say this exercise frequency could still be improved. The US Department of Health and Human Services recommends a minimum of 2.5 hours a week of moderately intensive exercise. What's more, a study by Harvard researchers recommends more intensive exercise if you want real benefits.
Mary Lyn Koval | February 24, 2023 | Contributor Information
As in last year's Medscape report, 58% of cardiologists answered yes to this question. Meanwhile, 53% of all physicians did for this year's report.
The National Bureau of Economic Research ran this choice by average American workers and found that 40% would take the pay cut. Perhaps the demands of medicine make the trade-off more appealing to doctors, or maybe it's a more manageable decision given their incomes.
Mary Lyn Koval | February 24, 2023 | Contributor Information
The news is mixed in terms of how much doctors drink. For example, the National Institute on Alcohol Abuse and Alcoholism defines "heavy drinking" as more than 14 drinks per week for an average man and more than seven for a woman. With 7% of physicians consuming seven or more drinks weekly, this indicates that they probably trail the approximate 6% of the US population with an alcohol use disorder.
On the other hand, about 34% of American adults drink no alcohol at all, according to the Centers for Disease Control and Prevention.
Mary Lyn Koval | February 24, 2023 | Contributor Information
Overall, 61% of physicians said they kept online use away from work at 10 or fewer hours per week. Eleven percent of them acknowledged they are on the internet after working hours for at least 21 hours per week.
So, how do doctors stack up against other Americans in terms of their internet appetite away from the office? Research from the USC Annenberg Center for the Digital Future showed that the average American spends about 18 hours each week online at home. A minority of physicians are on their phones and other devices that often.
Mary Lyn Koval | February 24, 2023 | Contributor Information
Comparable stats for online time for work by physicians in general are 67% for 10 hours or fewer per week, 19% for 11-20 hours, and 15% for 21 hours or more.
Mary Lyn Koval | February 24, 2023 | Contributor Information
In Medscape's report last year, 87% of all cardiologists (male or female) said they were married and 2% reported they lived with a partner. This year, 85% of all male physicians surveyed, and 72% of female doctors, were married; another 4% and 6%, respectively, lived with a partner.
Mary Lyn Koval | February 24, 2023 | Contributor Information
The ranks of cardiologists who chose "very good" or "good" to describe their marriages are similar to that in last year's report (82%). The same can be said for how often cardiologists said their marriages are "very poor" or "poor" (5% last year).
Overall, physicians experience marital turmoil similar to what's seen in the general public. The 24.3% divorce rate among physicians — while somewhat lower than in the general US population — shows that their marriages are failing frequently, a journal article's analysis found. And female doctors are divorcing more often than their male counterparts are.
Mary Lyn Koval | February 24, 2023 | Contributor Information
A large majority of cardiologists chose "very good" or "good" to describe their marriages. From year to year in our reports, there's no consistency in which specialists will lead or trail the pack with blissful marriages. Interestingly, though, in last year's report, the rate of happy marriages exceeded 85% in seven specialties. This time around, only two did.
Mary Lyn Koval | February 24, 2023 | Contributor Information
Compared with cardiologists, 69% of all physicians identified themselves as believers.
How do physicians compare with average Americans here? They're slightly less likely to be believers, apparently. A Gallup poll found that 76% of Americans identify with a specific religious faith (which doesn't include spiritual beliefs outside of a mainstream religion).
Mary Lyn Koval | February 24, 2023 | Contributor Information
Seventy-nine percent of doctors in general kept vacation time at 4 weeks a year or less, the same as in last year's report. The COVID-19 pandemic wreaked havoc on the number and length of family vacations, and it may take some time for long leisure trips to return in force.
Physicians discuss their personal and professional happiness, how they strive for work-life balance, and successes and failures in looking after their own physical and mental health.Medscape Features Slideshow, Jan 2023
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Mary Lyn Koval
Editorial Consultant
Medscape Business of Medicine
Disclosure: Mary Lyn Koval has disclosed no relevant financial relationships.
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