Of Millennials, Gen X, Boomers, Which Docs Have Highest Burnout?

Marcia Frellick

January 15, 2020

While every generation of physicians face varying degrees of burnout, those from generation X (ages 40-54) reported the highest burnout rates in a new Medscape survey.

In the Medscape National Physician Burnout and Suicide Report 2020: The Generational Divide, 48% of Gen X'ers said they were burned out compared with 39% of baby boomers (ages 55-73), and 38% of millennials (ages 25-39).

"Midcareer is typically the time of highest burnout," Carol A. Bernstein, MD, vice chair for faculty development at Montefiore Medical Center in New York City, told Medscape. That group is likely also juggling many roles outside work, many caring for children and aging parents simultaneously, she noted.

More than 15,000 physicians in 29 specialties responded to the survey.

Overall numbers for burnout have decreased in Medscape surveys from 46% 5 years ago to 44% last year to 42% this year.

Some Specialties Remain at Top in Burnout Scale

However, some of the same specialties have remained at the top in that time: neurology, urology, family medicine, critical care, internal medicine, and emergency medicine.

Urology and neurology were at the top this year (54% and 50% reported burnout, respectively) just as they were last year.

Public health and preventive medicine reported the lowest burnout rate (29%) followed by ophthalmology (30%).

The trend of women reporting more burnout than men also continued this year (48% to 37%).

More physicians were happy in their careers (59% were extremely, very, or somewhat satisfied) than were not. But that is lower than in many other professions.

Last year, a CNBC poll found that 85% of American workers were at least somewhat satisfied in their jobs.

Willing to Trade Pay for Balance

Across all three generations, almost half (49%) said they would be willing to take less pay for better work-life balance. From one quarter (millennials) to one third (baby boomers) said they would be willing to give up from between $20,000-$50,000 in salary for more personal time.

"Expectations about what a career as a physician is in the 2020s is changing," Halee Fischer-Wright, MD, CEO of the Medical Group Management Association told Medscape.

"Physicians recognize that seeing a smaller number of patients may give them more time with patients and the ability to practice medicine at the height of their license, reducing nonclinical hours and enhancing personal satisfaction, which ultimately may decrease burnout and extend their career life," she said.

Top Driver Remains Administrative Tasks

The top driver for burnout again this year was too many administrative tasks for all three generations (54%-57% put it at the top). Baby boomers were the only generation to list "increasing computerization of practice" among their top three concerns. Millennials listed electronic health record demands second to last in choosing from a list of top 10 concerns.

All three generations listed spending too many hours at work among their top three stressors.

Baby boomers, who have been a part of the trends from self-employment to employment and paper records to electronic records, were the most likely group (50%) to report that burnout has severely affected their life, compared with 46% of Gen-X'ers and 36% of millennials who answered that way.

However, millennials were more likely to report that burnout has strained their relationships. Among them, 77% said it had affected relationships, vs 69% of baby boomers.

Asked how they cope with burnout, physicians overall listed isolating themselves and exercise as their top strategies (45% each), followed by talking with close friends/family members (42%) and sleep (40%).

Tragically, some reports say that an estimated 300 to 400 physicians each year choose suicide. This survey indicates that 1% of male physicians and 2% of female physicians have attempted it.

Almost one quarter of physicians (23% of male physicians and 22% of female physicians) have had thoughts of suicide but have not attempted it.

The percentages of those who have had suicidal thoughts or have attempted it were very similar across all three generations.

Fix the System, not the Physician

Still, few seek help in any generation. Only from 12%-14% said they are currently seeking help; from 61%-64% said they have not sought help in the past and do not plan to.

Additionally, only 28% of physicians overall said their workplace offered programs to help reduce burnout or stress; half said they did not.

A cardiologist who responded to the survey said, "I don't think burnout is a psychiatric problem or my personal problem. I think it is inherent in the present way of healthcare delivery, at least in the US."

Wendy Dean, MD, a psychiatrist and founder of moralinjury.healthcare, an advocacy organization working to counteract the 'moral injury' of healthcare professions, agrees. The organization's website reads at the top:
"Moral Injury – It's NOT burnout."

She told Medscape that although healthcare organizations often focus on wellness for physicians, such as yoga and self-care, "finding solutions requires that we address the problem for what it really is: a challenge inherent in the structure of the healthcare industry."

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