Burnout Might Really Be Depression; How Do Doctors Cope?

Leigh Page

Disclosures

January 17, 2018

In This Article

Many Depressed Physicians Don't Get Treatment

Physicians often do not seek treatment for depression because doing so can lead to licensure restrictions, limits on hospital privileges, and extra follow-up examinations.

"Physicians cannot talk honestly about what is happening," says Pamela Wible, MD, a family physician in Eugene, Oregon, who speaks on physician depression and runs a suicide hotline for doctors. In an informal survey of physicians, Dr Wible found that a majority had been depressed at some point in their career, but only about a third sought professional help.[2]

"Some physicians with depression drive hundreds of miles to get treatment so that they won't be identified," Dr Wible said.

Does Depression Affect Patient Care?

In Medscape's Burnout & Depression Report, one third of depressed physicians said their condition affected patient care. Specifically, 33% said they were more easily exasperated by patients, 32% said they were less engaged with patients, and 29% said they were less friendly with patients. (Physicians could select more than one answer.) More concerning, 14% said that due to depression, they might make errors that they wouldn't ordinarily make, and 5% said they've made errors that could harm patients.

Higher numbers of respondents said their depression affected dealings with colleagues and staff. Fully 42% indicated exasperation with colleagues, another 42% indicated less engagement with colleagues, and 37% said they expressed their frustration in front of staff or peers.

Burnout is a serious problem, but its severity may differ in different circumstances, Dr Myers says. "Doctors may only feel burned out on a particular day or time of day," he says. Dr Schonfeld adds that researchers use five different burnout measures, including the most well known, the Maslach Burnout Inventory.

In addition to dealing with sheer overwork, every specialty may have its own unique causes of burnout, Dr Myers says. "For critical care specialists, burnout can involve moral conflicts when dealing with families who want to have everything done for dying patients," he says. "For trauma surgeons, burnout might involve having to treat the perpetrator and the victim at the same time."

How do physicians usually deal with burnout? Half of them cope by exercising. Almost half (46%) talk with family members or close friends; 42% go to sleep; 36% want to be alone. Smaller percentages take a different route: 22% drink alcohol; 20% binge eat; 2% use prescription drugs.

Higher Burnout Rates for Women, Midcareer Physicians

In this year's report, as in prior years', a higher percentage of female physicians reported burnout: 38% of men and 48% of women.

Why the significantly higher rate for women? "Female physicians often are the chief parent and homemaker in their home," Dr Wible says. "Also, women often have a greater need for relationships than men and suffer more when they don't have them."

In Medscape's survey report, a far higher percentage of women than men (55% vs 39%) said they discussed their burnout with family and friends. In addition, 31% of women said they had found or were planning to find professional care for burnout or depression, compared with 24% of men.

Another group more likely to be burned out is midcareer physicians, Medscape's report showed. The burnout rate for doctors aged 45-50 years was 50%, compared with 35% for doctors under age 45 years and 41% for ages 55-69 years.

The reason? Midcareer physicians work longer hours, take more night calls, and handle more medical group responsibilities than other age groups, according to one analysis.[3]

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