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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018
| Contributor Information
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Burnout continues to be a pervasive issue among doctors. In October, the Society of Occupational Medicine estimated that between 30% and 40% of UK doctors, including trainee and junior doctors, are experiencing burnout and work-related stress, with GPs reported to be most at risk. NHS England's chief executive Simon Stevens announced a new mental health support scheme for all doctors working in the NHS. In our first Medscape UK Doctors' Burnout & Lifestyle Report we focus on responses to our survey questions about burnout and depression. How prevalent are these factors, and how do they affect doctors' lives? We also explore home life and work life issues. Demographics and survey details can be found at the end of this presentation.
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Doctor Burnout and Depression
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Doctor Burnout and Depression
Nearly a third of 968 doctors (32%) responding to our survey reported feeling burned out at some stage and 14% said they were depressed. That compares with depression prevalence estimates for the general population in England of 3.3%, according to the mental health charity Mind. Of those describing their depressive feelings, 25% said clinical depression while 57% said feeling down, blue, or sad. Feeling both depressed and burned out applied to 10% of respondents.
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What Contributes to Doctors' Depression?
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
What Contributes to Doctors' Depression?
Jobs were a significant cause of depression for 63% of those who reported experiencing it. The next most common cause was money worries at 20% and then family issues, and romantic relationships. Health was mentioned the least. Of those experiencing burnout and depression, 82% felt the burnout contributed to their depression.
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Does a Doctor's Depression Affect Patient Care?
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Does a Doctor's Depression Affect Patient Care?
Does having a doctor with depression have an impact on their patients? As far as the doctors themselves were concerned, half said not. Where other respondents felt their depression affected patients - being less engaged, more easily exasperated, and less friendly, were the most common impacts mentioned. When it came to errors, 14% said being depressed made errors more likely, with 3% saying they made errors with the potential to cause patient harm.
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Does a Doctor's Depression Affect Dealings With Colleagues and Staff?
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Does a Doctor's Depression Affect Dealings With Colleagues and Staff?
Aside from patients, can a doctor's depression affect their workplace and impact on colleagues? Workplace behaviour was not impacted according to 19% of those who reported depression. Where depression did affect the workplace, the most common themes were being less engaged, more easily exasperated, and being less friendly, with colleagues and peers.
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How Often Do Doctors Experience Burnout?
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
How Often Do Doctors Experience Burnout?
When those doctors experiencing both burnout and depression were asked if the burnout contributed to their depression 82% said it did. Two percent said it did not, while 15% didn’t know. When it came to the frequency of burnout, responses ranged from 3% saying rarely to 4% saying always, with most responses clustered around the middle options on a scale of 1 to 7.
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Severity and Duration of Burnout
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Severity and Duration of Burnout
When asked to rate the impact of burnout severity from not interfering with life to being so severe it could result in leaving medicine altogether, 1% opted for the least impact while 12% chose the most severe with 70% of responses clustered on the middle options. Two thirds of doctors who'd experienced burnout said it lasted a year or longer.
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What Contributes to Doctors' Burnout?
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
What Contributes to Doctors' Burnout?
As you might expect in an organisation as vast as the NHS, overall the most common reason for burnout was too many bureaucratic tasks, with 47% citing this factor. The next most common causes were long working hours, a lack of respect from administrators, colleagues or staff, and not being paid enough for the job. Bureaucracy and long working hours were more of an issue with doctors in general practice than those in hospitals. Specialists also cited these factors less than generalists did. One mental health doctor told us there's "Not enough time or resources to do the job properly whilst at the same time being expected to do ever increasing amounts of defensive paperwork and toxic bureaucracy and at the same time being expected by the state to adhere to unrealistic guidelines."
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How Has Burnout Affected Your Life?
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
How Has Burnout Affected Your Life?
Digging deeper into the impact on doctors' lives from burnout, one told us how they left the NHS for part-time work: "I recognise that if I stayed in the NHS, the stress would literally kill me." Another described how they experience PTSD that hasn't been helped by work. The impact on home life was described by another respondent: "Feeling disengaged socially at home and spending lots of time doing nothing. Sleeping longer." And for another who was burned out and depressed: "Divorce. Limited access to children. Hate job. Wish I had alternative career." Another described the financial pressure after taking a pay cut to go into emergency medicine: "High stress levels. Exhaustion. Reduced family life due to work load. Feel unappreciated for high level of responsibility." Another doctor who experienced burnout described "continuous preoccupation of how to deal with problems for which there are insufficient support staff and little options for solving".
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What Would Help Reduce Burnout?
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
What Would Help Reduce Burnout?
So what could help reduce burnout? Overall the main requests were for adjusting patient loads and working/on-call hours. These were followed by receiving greater respect, better pay to help avoid financial stresses, and less red tape. Patient workloads and working hours improvements were more likely to be cited by general practice based doctors than those working in hospitals. For those in hospitals respect was more of an issue. One mental health doctor suggested: "Get rid of the pseudo-corporate structure of the NHS. Get rid of executives and all middle managers. Give power back to clinical staff. Stamp out bullying."
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Seeking Help for Burnout or Depression?
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Seeking Help for Burnout or Depression?
Schemes are available in the NHS, such as England's free NHS Practitioner Health Programme. So have physicians experiencing burnout or depression sought professional help, or are they planning to seek help? Six in 10 said not. Only 1 in 10 of those burned out or depressed are either getting help or are planning to. When asked why not, the main reasons were not considering the symptoms severe enough, being able to deal with symptoms themselves, and being too busy. Nearly 1 in 5 didn’t want to risk disclosure, while 6% didn’t trust mental health professionals.
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Where to Seek Professional Help?
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Where to Seek Professional Help?
When all physicians were asked if programmes to reduce stress and burnout were available at work, 46% said not. A further 36% weren't sure. Among those seeking help for burnout or depression most said they'd use a psychologist, therapist or counsellor, followed by a Practitioner Health Programme, and a psychiatrist. Nearly 1 in 8 would turn to peers or colleagues for help. For those without access to a workplace programme, 2 in 5 said they would be likely to use it. However, where workplace programmes are available, only 1 in 5 of all respondents said they'd used them.
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Taking Action to Reduce Burnout
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Taking Action to Reduce Burnout
Among UK doctors who've experienced burnout taking early retirement was the solution more than half took, and this was more common among male and older doctors. That approach was followed by a career change away from medicine, a different job within medicine, and changing to a different type of medical practice. Looking for a different job in medicine or a different type of practice was more common among generalists than specialists. In the workplace, 36% of burned out doctors said they'd reduced working hours. Others eased workload with staff or workflow changes (13%), or discussed productivity pressures with administrators (16%).
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
It isn’t all doom and gloom. More than a third of all doctors are very or extremely happy with their working lives – with men more likely to be happy than women. Meanwhile, more than 6 in 10 of all doctors said they are very or extremely happy in their life outside of work. One GP told us: "I have a very good work life balance being part-time and great partners who I get along with and support me in times of stress either at work or home." Another said: "I have satisfaction and continued excitement in my work and the difference I know I am making - makes for a good place to be mentally." One hospital-based doctor wrote: "I like my job. I feel hospital is my home and work colleagues and patients are my family members." However, another commented: "I left the NHS 4 years ago, which was the source of stress, fatigue, unhealthy working environment and stifled clinical involvement in governance and service development."
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
With exercise being linked to better mental health, 67% of doctors told us they exercise regularly at least twice a week. Just over 1 in 10 exercised daily, whilst the same number didn’t exercise at all. One in 20 doctors said they still smoke, while 1 in 50 vape or use e-cigarettes. When it comes to alcohol around 6 in 10 doctors stay below the recommended 14 units a week. A fifth don’t drink at all but a similar number drink more than the guideline amounts. One percent admitted to using cannabis or 'recreational' drugs. It isn’t just patients battling with their waistlines. Nearly half of respondents are actively trying to lose weight.
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
When it comes to lifestyle actions in response to burnout, around 4 in 10 took positive actions, including talking to family and friends and taking exercise, and sleep. However, isolation was the most common response for more than 4 in 10, and was more common in under-45s than older doctors. Around 3 in 10 said they turned to alcohol, junk food, or binge eating. Junk food was more common among women and under-45s.
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Eight out of 10 respondents are married, in a civil partnership, or living with their partner. That's higher than the figure of 61.4% in the general population living as a couple in England and Wales, according to the Office for National Statistics. Men in our survey are more likely to be married than women, as are over-45s.
A third of doctors in our survey have spouses who are also physicians, while a further 1 in 5 are married to someone working in another healthcare role. Among spouses, 44% are employed full-time and 19% employed part-time. One in 10 doctors are single – more than twice as many women as men – and three times as many under-45s than over-45s. Forty-five percent of respondents have at least one child living at home, with one or two children being most common. In line with the UK's ageing population with increasing co-morbidities 1 in 5 doctors in our survey are carers for family members other than their children – 14% for their parents, 5% for other family members.
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Not counting social media friends, nearly 8 in 10 doctors in our survey reported having between one and six close friends, with one to three being the most common. When it comes to being introverted or extroverted, 32% said they are more introverted, 25% more extroverted, while 42% think they are evenly balanced between the two. Half of doctors said they have a religious or spiritual belief with nearly three quarters of these saying their beliefs help them cope with challenges at work.
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Most NHS staff in the UK are entitled to 5.6 weeks’ paid holiday a year, which may include bank holidays. While 54% of respondents take more than 5 weeks holiday a year, 30% only take 3-4 weeks, 13% 1-2 weeks, and 3% less than a week. Under-45s were more likely to take fewer weeks holiday than over-45s. The most weeks holiday were taken by generalists rather than specialists.
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
As you might expect 80% of respondents work solely in the NHS, 9% work solely in private practice, and 11% in both the NHS and private practice. Of these, almost two out of three doctors are hospital-based and 18% in general practice. Employee status applied to 76%, while 13% were independent contractors, 9% partners, and 3% in single-handed practice. Nearly two-thirds worked in town or city centres, 27% in the suburbs, and 10% in rural areas.
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
General practice was the biggest single group among our top five respondents' specialties, followed by anaesthetics, psychiatry, paediatrics, and emergency medicine.
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
Working long hours was the second biggest factor mentioned in our survey contributing to burnout. Of full-timers, 24% work more than 50 hours a week. Of those working 41-60 hour weeks, there were more men than women. Specialists were more likely to work 41-60 hours than generalists – 69% vs 39%. Long hours were also more common in hospitals than elsewhere. Part-timers – working fewer than 40 hours a week – made up 38% of doctors responding to our survey.
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Medscape UK Doctors' Burnout & Lifestyle Survey 2018
Tim Locke | December 18, 2018 | Contributor Information
A total of 968 UK doctors completed the survey. There was a spread of age groups in our survey from late 20s to past the state retirement age. Most doctors worked in England, followed by Scotland, and then equal numbers from Wales and Northern Ireland. The gender balance was 56% male, 44% female. Data was collected online between April 25th and June 19th 2018. The margin of error for the survey was 3.17% at a 95% confidence level using a point estimate of 50%. Some totals in this presentation do not equal 100% due to rounding.
What's the financial situation for UK doctors? Which are the factors affecting income, challenging aspects of their jobs, and thoughts on future plans such as the impact of the UK leaving the EU after Brexit? See the results of our first UK-specific Medscape income survey.
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