COVID Cuts Internists' Happiness in Life Outside Work

Marcia Frellick

February 22, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Before the pandemic, a large majority of internists reported that they were generally happy with life outside of work, although by specialty, they were near the bottom in happiness.

But this year's Medscape Internist Lifestyle, Happiness & Burnout Report 2021 shows a sharp drop, with just 55% of respondents saying they are somewhat or very happy in life outside work, compared with 78% last year.

Internists were not alone among the more than 12,000 physicians who responded to the survey. The contrast from last year's report was clear for physicians in general and reflects COVID-19's substantial toll on clinicians.

Just 58% of physicians overall reported happy lives outside work, down from 82% last year.

Perhaps not surprising, given the particular demands on certain specialties, physicians in infectious disease were the least happy, at 45%, followed by pulmonologists (47%) and rheumatologists and intensivists, at 49%.

The highest happiness level was reported by those in diabetes and endocrinology, at 73% this year, but that proportion was also substantially lower than the 89% from last year.

Burnout Persistent

The percentage of internists who reported burnout or depression, however, has stayed fairly consistent. This year, 46% reported being either burned out or burned out and depressed, as opposed to 44% last year.

More than half (52%) said that burnout had a strong or severe impact on their lives, and nearly 1 in 10 said it was severe enough that they are considering leaving medicine.

One percent of the internists who responded to the survey said they had attempted suicide, and 12% said they had thoughts of suicide but had not attempted it.

Most of those reporting burnout (82%) said it started before the COVID-19 pandemic, but 18% said it began with the pandemic.

Notably, though, physicians ranked problems related to stress from COVID-19 near the bottom among burnout drivers. The top factor, by far, again was "too many bureaucratic tasks."

Table.

What contributes most to internist burnout?* Percentage who said it was a top driver
Too many bureaucratic tasks 66
Spending too many hours at work 36
Insufficient compensation/reimbursement 34
Increasing computerization of practice 33
Lack of control/autonomy 29
Lack of respect from administrators, employers, colleagues, or staff 29
Lack of respect from patients 19
Stress from social distancing/societal issues related to COVID-19 15
Government regulations 13
Stress from treating COVID-19 patients 10
Other 8
*Physicians could pick more than one answer.

 

A large majority (78%) of internists work online for up to 10 hours a week, a number that could grow as telemedicine grows.

Exercise Is Top Coping Method

Responses gave a peek into how physicians are coping with burnout. Among internists, 49% put exercise at the top. Isolating themselves from others was the next most popular choice, at 45%. Eating junk food and drinking alcohol were further down the list, at 34% and 24%, respectively.

Few internists said they drink alcohol daily, a finding consistent with past years. In fact, 29% said they don't drink at all, and 26% said they have fewer than one alcoholic drink per week. Only 7% said they had seven or more drinks per week.

The National Institute on Alcohol Abuse and Alcoholism advises that men not have more than 14 alcoholic drinks per week and that women not have more than seven.

Work-Life Balance Topped List of Concerns

By far, internists said work-life balance was their top workplace concern. Nearly half (48%) chose that answer, more than twice the percentage who said compensation was the biggest concern (21%).

Asked whether they would take a salary cut for more work-life balance, a similar proportion (46%) said yes.

Forty-three percent of internists manage to take 3 to 4 weeks of vacation, and 10% take at least 5 weeks, similar to reported vacation time in last year's survey.

The vast majority are in committed relationships, with 79% reporting that they are married and 5% reporting that they are living with a partner.

Of those who are married, 48% described the marriage as very good; 32%, good; 16%, fair; 2%, poor; and 1%, very poor; 1% preferred not to answer.

One in five internists said their spouse was a physician, and 24% said their spouse worked in the healthcare field but not as a physician.

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune and Nurse.com and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick.

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