Swipe to advance
1 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Medscape UK's latest survey of 1082 doctors, carried out online 29 May to 24 August, finds burnout is a major challenge, especially during the pandemic and lockdown.

This year we also look at how different generations have been affected: Millennials (24-39), Generation X (40-55), and Baby Boomers (56-74).

Totals may not equal 100% due to rounding.

2 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

  • Overall levels of burnout among UK doctors increased by 68%, from 22% when we last asked in 2018 to 37% this year during the pandemic.
  • Generation X and Millennials were significantly more burned out than Baby Boomers.
  • Overall depression had also risen from 4% in 2018 to 5% this year. Those reporting being both burned out and depressed nearly trebled from 10% in 2018 to 28% this year.
  • Those reporting neither burnout nor depression more than halved from 64% to 30%.

Female doctors were almost a third more likely to be burned out than their male counterparts were. Female doctors were around 30% less likely than males to report neither burnout nor depression.

3 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Among doctors reporting burnout, working during the pandemic made feelings of burnout more intense for 68%. There was no change for 22% and it was less intense for 10%.

Additionally, burnout intensity was slightly more evident in female doctors (70%) than males (66%). Females were also less likely to report burnout being less intense (8% vs 13%).

Less burnout intensity was also more common among the Baby Boomers (15%) than Millennials (7%), and Generation X (8%).

Our findings follow an April 2020 BMA member survey that found 44% of doctors experienced depression, anxiety, stress, burnout, or other mental health conditions relating to or made worse by their work.

4 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Experiencing a lack of respect, too much bureaucracy, and too many hours at work were the top three contributors to UK doctors' burnout.

The three generations of doctors felt frustrations in different ways. Millennials were most concerned about their long working hours. Lack of respect and bureaucracy were equally most concerning for Generation X. A lack of respect also caused most concern for Baby Boomers, closely followed by bureaucracy.

Pay was less of an issue for the older baby boomers. Computerisation was more of an issue for the oldest doctors and less so for the youngest.

5 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

If employers wanted to help reduce UK doctors' burnout, reducing patient caseloads would be the most popular measure, closely followed by receiving greater professional respect, and more manageable working patterns.

There were gender differences with the male top three being respect, autonomy, and pay/patient loads. The female top three were patient load, work pattern, and professional respect.

Across the generations:

  • Millennials were most concerned about work patterns, pay, and patient loads
  • Generation X looked for help on patient loads, professional respect, and work patterns
  • The older age group (Baby Boomers) was concerned about professional respect, patient loads, and autonomy

GPs were more than twice as concerned about patient loads than specialists were (63% vs 28%).

Specialists were nearly three times more concerned than GPs about professional respect (37% vs 13%).

There were some significant changes since our last survey in 2018, including a wish for decreased regulations dropping from 23% to 15%, and emphasis on patients over costs dropping from 15% to 10%.

6 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Seventy-two percent of all UK doctors in our survey told us they work full-time.

Doctors in the oldest age group, the Baby Boomers, were most likely to work the most hours per week, but were also most likely to work fewer than 30 hours a week.

GPs were more likely than specialists to work under 30 hours a week (53% vs 22%).

Specialists were more likely than GPs to work the most hours per week (7% vs 5%).

7 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

The mobilisation of the NHS to deal with COVID-19 saw more than a third of UK doctors in our survey working longer hours.

However, hours stayed the same for 43%. Nearly a quarter worked fewer hours. This might reflect a 'pause' in some specialist services, such as cancer diagnosis and treatment.

GPs were slightly more likely to work longer hours due to the pandemic than specialists were (37% vs 35%). Specialists were more likely than GPs to work fewer hours (22% vs 19%).

We also asked whether efforts were made to reduce paperwork/administrative tasks to allow a better focus on COVID-19. Of those it applied to, only 27% said efforts had been made, 73% said they hadn't.

The admin burden was most likely to have been reduced for GPs than specialists (48% vs 22%). This may reflect CQC and other inspections being paused.

8 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

We asked if doctors and healthcare professionals should be paid COVID-19 overtime or danger pay. More than half said they should but more than a quarter said not, and just under a fifth were not sure.

Millennials was the generation most in favour of extra COVID-19 pay: 71% in favour, compared with 57% for Generation X, and 45% for the Baby Boomers.

In July, most doctors in England were awarded an above-inflation 2.8% pay rise said to be in recognition of coronavirus frontline work. The BMA called it "a metaphorical slap in the face".

9 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

During the early stages of the pandemic and lockdown the public was encouraged to step outside each Thursday night to 'clap for carers'.

Back in April, our Emergency Department commentator Dr Dan O'Carroll wrote that "as the death toll of the population at large and health care workers rises, the clapping seems even more poignant and emotional. It is nice for the NHS to finally feel valued by the public and Government."

By the time we did our survey had it still made a difference? No, nearly 7 in 10 said.

10 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Doctors' burnout was so severe that more than a quarter were considering leaving medicine. Millennials and Baby Boomers were more affected than Generation X. Male doctors were more affected than female counterparts (27% vs 24%).

We asked how often doctors experience burnout. Millennials were more likely than Generation X and Baby Boomers to say 'rarely' (10% vs 3% & 5%).

Generation X was less likely than the other generations to say 'always' (4% vs 8%).

For almost one in two (44%) of those experiencing burnout it has been going on for a year or more. This duration of burnout was around 50% more common for men than women (53% vs 36%). However, the number of people experiencing burnout for 2 to 6 months had almost doubled this year compared to when we asked in 2018 (30% vs 16%).

11 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Millennials' relationships were affected far more than the other generations.

Among the other ways burnout had affected doctors' lives were:

"I am so angry at how my life and dedication to medicine has been used and abused.

"I am no longer the person I used to be."

"I feel numb…I fall asleep on the sofa every night. My sleep is bad. I am irritable."

"I have had enough and I don't want to fight anymore."

"I sleep a lot, and it doesn't take much to make me cry. I snap at everyone."

"I felt that no matter how hard I worked, I was always expected to do more."

"Permanently tired, angry, and procrastinating."

"I absolutely dread coming to work."

"Not interested in having friends or sex, less engaged at work, constantly feel tired and exhausted."

"Made me feel a useless, worthless doctor."

"Counting down the hours to zero days, weekend, or annual leave."

"It's ruined work for me."

"I am thinking about early retirement but can't afford it financially."

"I feel like a hamster in a wheel, wake up, go to work, come home."

"I just feel like a bullied doctor. Bullied by organisations which should be protecting me."

"I'm no fun to be around."

"Grumpy with family and others and they do not deserve this."

"I am just knackered and very unenthusiastic about medicine."

"Snappy and argumentative with my partner."

"Feeling overwhelmed and unable to get everything done."

"I rant more. I feel like I'm on a treadmill of work."

"I hate working. I find patients annoying, even when they are in pain."

"COVID-related burnout has spilled over into home life."

"I feel like a trapped animal sometimes."

12 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

The healthy option of exercise was the most popular way doctors told us they coped with burnout. More GPs chose exercise than specialists did (57% vs 46%).

Alcohol was a more common choice among men than women (38% vs 27%), with junk food being more common among women than men (34% vs 22%).

Junk food and binge eating was more common among Millennials (48% & 34%) than Generation X (26% & 18%), and Baby Boomers (20% & 16%).

13 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Early retirement was the most common career option considered by UK doctors to help with burnout, and this was more likely to be considered by men than women (57% vs 39%).  

Among the other choices, looking for a different job in medicine was a more common choice among GPs than specialists (45% vs 29%).

The older Baby Boomers were more likely to consider early retirement (74%) than the other generations.

The youngest group, the Millennials, were more likely to consider leaving medicine (53%). This group were also most likely to choose looking for a different job in medicine (40%), and changing to a different type of practice (29%), than the other age groups.

Steps taken within the same job included reducing hours (27%), changing work setting (15%), and discussions with managers about productivity pressures (15%).

14 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

When asked to describe how they were feeling most doctors said they were feeling down, blue, or sad. Almost 1 in 5 (18%) said they had clinical depression, and this was around three times more common in the younger Millennials group than it was in the older Baby Boomers.

Burnout contributed to depression for 84% of doctors experiencing burnout and depression.

Although work isn't the only possible contributing factor for depression, it was by far the most common in our survey (67%). Next came family (16%), finances (14%), romantic relationships (14%), and health (13%).

Jobs contributed more significantly for the middle Generation X (52%), than it did for the younger Millennials (41%), and older Baby Boomers (36%).

15 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

While most doctors experiencing depression didn't think it affected their relationships with patients, there were areas of concern for others. These included being less engaged, more easily exasperated, and being less friendly.

GPs were more likely to be exasperated with patients than specialists were (39% vs 23%). When it came to the risk of making mistakes, Millennials were more than twice as concerned as Baby Boomers (22% vs 10%).

When it came to depression affecting the workplace and colleagues, 18% said there was no impact. However, concerns for others included:

Being less engaged

49%

Being more easily exasperated

45%

Expressing frustration

37%

Less friendly

36%

Arriving late to work

19%

Making uncommon errors

14%

Taking longer lunch breaks

8%

Making errors that could cause harm

3%

16 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Most doctors who chose to answer this question about their burnout or depression said they weren't planning to seek professional help and hadn't sought professional help in the past.

Those who have sought, are seeking, or plan to seek professional help chose the following sources of help:

Counsellor/therapist/psychologist

54%

Practitioner health programme

25%

Psychiatrist

11%

Peers/colleagues

10%

GPs were far less likely to consult a counsellor/therapist/psychologist than specialists were (37% vs 58%).

The middle Generation X doctors were more likely to consult a psychiatrist than younger Millennials or older Baby Boomers (16% vs 5% vs 8%).

17 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Nearly half of doctors (48%) experiencing burnout/depression said they could deal with it without professional help, and 47% said symptoms were not severe enough. Mistrust of mental health professionals was a concern for 6%. Participants could pick more than one answer.

Around twice as many Millennials compared with Baby Boomers were concerned about the risk of disclosure (23% vs 12%).

18 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

One in 5 doctors who answered our question on suicide said they'd had suicidal thoughts but hadn't acted on them. There were few gender or generational differences in the data.

In our survey 1% of doctors had attempted suicide. Office for National Statistics data for England and Wales show 141 suicides among medical practitioners 2011-2018.

19 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Among doctors who had attempted or considered suicide, 54% did not seek help from anyone. Millennials were far more likely to talk to a friend or colleague than were Generation X or Baby Boomers.

Among those who had not talked to a mental health professional, the main reasons were:

I can deal with this without help from a professional

44%

Don't want to risk disclosure

40%

Concerned about it being on my medical record      

38%

Concerned about my colleagues finding out             

27%

Concerned the medical profession will shun me       

21%

I don't trust mental health professionals                    

9%

Other

18%

Baby Boomers were far less concerned about it appearing on their medical record (17%) than the younger Millennials (52%) and Generation X (48%).

20 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

The NHS has work to do with regard to promotion of its workplace programmes for doctors with stress/burnout. Our data show 70% were aware of services but 30% were not. Among those who were aware of the programmes, 12% had used them.

Among those who said their workplace didn't have a stress/burnout programme, the older Baby Boomers were least likely to use a future service (36% 'very unlikely'), compared with Millennials (28%) and Generation X (19%).

21 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Overall, fewer than 1 in 5 UK doctors described themselves as unhappy to any degree outside work.

Millennials were the most unhappy generation, and Baby Boomers were happiest, slightly ahead of Generation X.

Since we last asked in 2018, overall unhappiness outside work rose from 15% to 19%. Overall happiness fell from 78% to 71%.

22 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Millennials were the generation who were most unhappy to any extent, and Baby Boomers the happiest.

Overall, more doctors were unhappy than happy (46% vs 37%).

Since we asked in 2018, unhappy doctors increased by nearly 50% from 31% to 46%, and happy doctors fell by around a third from 58% to 37%.

Comments from happy doctors included:

"I do not have any grievances and after a lifetime of radiology I have learnt how to handle daily challenges that I find more stimulating than depressing."

"The patients' support and goodwill and my sense of duty keeps me going."

"I take one day at a time and focus on positives and ways of making the negatives better."

"Whilst it is easy to gripe about things that are wrong this just saps your will."

"My job is awesome."

23 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

More Baby Boomer doctors found time for their own personal health and wellness than the other generations.

Around twice as many Millennials reported never finding the time compared to other generations.

Overall, 1 in 5 doctors found time for their own health and wellness most of the time, with more men than women (23% vs 17%), and more GPs than specialists (24% vs 19%), reporting this.

24 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Most UK employees are legally entitled to 5.6 weeks of paid holiday a year (known as statutory leave entitlement or annual leave). While half of doctors told us they take this leave or longer, the other half didn't.

Some self-employed doctors may choose different holiday options, and this year due to the pandemic, employees are allowed to carry over unused holiday to the following 2 years.

Millennials were least likely to take their full holiday entitlement.

More specialists than GPs don't take their full allowance (54% vs 36%), and men were more likely than women to take less holiday than their allowance (54% vs 46%).

25 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

If money can't buy happiness would doctors take a pay cut if it gave them a better work-life balance or more free time? Yes, said 51%. No, said 49%.

When it came to the question of how much salary to sacrifice for a 20% reduction in weekly working hours, Millennials were the most likely generation to consider giving up £10,000 or less. The older Baby Boomers, probably further advanced in their careers and earnings, were the most likely of all the generations to consider giving up £10-20,000.

There was an overall reluctance to give up more than £20,000.

GPs were more likely than specialists to give up £10,000 or less (81% vs 73%), with more women than men being willing to give up the same amount (76% vs 72%).

26 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

With the stress many doctors told us they're under we wanted to know about their unhealthy habits.

Six percent smoke tobacco, lower than the 14.1% of the general population.

Two percent vape with e-cigarettes, this was more common among the younger Millennials (3%) than Generation X (1%) and Baby Boomers (2%).

Two percent use cannabis or recreational drugs. This was more prevalent among the younger Millennials (4%) than Generation X (2%). Amongst the Baby Boomers, no drug use was recorded.

Alcohol consumption was more prevalent with only 23% of all doctors saying they are teetotal.

With UK guidelines recommending no more than 14 alcohol units a week (a standard glass of wine is 2.1 units) on a regular basis, nearly a quarter of doctors (22%) were not following the advice they give their patients.

This pattern of drinking was more prevalent in the Baby Boomers (27%) than the Millennials (15%), and Generation X (19%).

27 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

We've already heard how exercise was the most popular way doctors coped with burnout, but how often do they exercise?

Only 9% of all doctors told us they don't exercise. That was more common among younger Millennials than the older generations.

GPs were more likely to exercise every day than specialists (16% vs 12%).

When it came to doctors' weight, nearly half (48%) were trying to shed some pounds, and nearly a quarter (24%) were working to maintain their current weight.

More women than men were trying to lose weight (51% vs 45%), and more GPs than specialists were trying to cut their weight (52% vs 47%)

28 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

The answers to the survey so far have been from practising doctors. But we also wanted to hear from those who had retired. Earlier we heard that 47% of burned out doctors were considering early retirement.

Of retired doctors who took part, 43% had taken early retirement. We asked them why.

Burnout, exhaustion, breakdowns, health reasons, and pension tax changes were common answers.

Here are some of their comments:

"Thankfully, I got out before work caused any serious health issues."

"I found working in A&E too stressful and working 12 hour night shifts were impossible to do anymore."

"Tired. Victim of unnecessary GMC investigation. Cleared."

"I had had enough, was very tired and jaded."

"Family circumstances. Also fed up with NHS bureaucracy."

"Too much work and too little time to do the job properly."

"I found the burden of paperwork and pressure and loss of control of my work practices too stressful."

"I was killing myself."

29 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

Most doctors in our survey work in the NHS (86%), 3% in the private sector only, and 11% in both.

Most participants work in England (82%), followed by Scotland (9%), Wales (5%), and Northern Ireland (3%).

30 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

31 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

32 of 33

Scroll

Medscape UK Doctors' Burnout & Lifestyle Survey 2020

Tim Locke | November 2, 2020 | Interessenkonflikte

33 of 33

Start
 

Medscape UK Ethics Report 2020: COVID-19, Life, Death, and Pain

UK doctors wrestle with many difficult issues as they care for patients and make treatment decisions. Here's how they feel about some tough issues.
1 26 Next