In the wake of the COVID-19 pandemic, physicians continue to experience burnout at alarmingly high rates. In a recent survey of 2440 physicians, approximately 63% of respondents reported having at least 1 manifestation of burnout in 2021; this was higher than all 4 prior assessment time points since 2011. Because physician burnout is more common in certain specialties, it is crucial to identify trends and offer help to those at higher risk. This article examines the symptoms, causes, and prevalence of burnout among clinicians in various specialties, and outlines strategies physicians can use to address burnout.
What Is Physician Burnout?
The American Medical Association (AMA) defines physician burnout as a long-term stress reaction that can include the following:
Emotional exhaustion;
Depersonalization (lack of empathy for or negative attitudes toward patients); and
Feeling of decreased personal achievement.
For many clinicians, symptoms of burnout were accelerated by the COVID-19 pandemic. During the pandemic, chronic stress due to work overload, exposure to infected patients, lack of protective equipment, and poor efforts to control infection rates increased the risk of burnout. Other factors associated with burnout include system inefficiencies, administrative burdens, and increased regulation and technology requirements.
The consequences of physician burnout affect patients as well as clinicians. From a patient’s perspective, physician burnout can result in poor physician/patient rapport, adherence to treatment, and treatment outcomes. For physicians, burnout can lead to declining mental health and subsequent depression, substance abuse, and suicide.
Physician Burnout: Which Specialties Are Most Affected?
Although burnout affects clinicians in all specialties and practice settings, the rate is higher in certain specialties. The AMA’s Organization Biopsy® is an assessment tool large health care organizations can use to measure and improve the health of their organizations. One of the parameters this tool measures is burnout.
The AMA’s 2022 Organizational Biopsy received more than 13,000 responses from physicians and other clinicians from more than 70 organizations in 30 states. The specialties with the highest rates of burnout were as follows:
Emergency medicine: 62%;
Hospital medicine: 59%;
Family medicine: 58%;
Pediatrics: 55%;
Obstetrics and gynecology: 54%; and
Internal medicine: 52%.
Medscape conducts an annual survey on physician lifestyle and happiness that includes questions about burnout and depression. In 2023, this 10-minute online survey included input from 9,175 physicians in 29 specialties. Overall for all specialties, 36% of respondents said they felt burned out, 5% said they felt depressed, and 18% said they felt both burned out and depressed. Based on the Medscape 2023 survey results, the following sections summarize the rates of burnout and depression among physicians clinicians working in emergency medicine, family medicine, pediatrics, obstetrics and gynecology, and internal medicine.
Burnout in Emergency Medicine
In Medscape’s 2023 survey, emergency physicians reported the following8:
42% felt burned out;
4% felt depressed; and
23% felt both burned out and depressed.
Burnout was reported by a higher proportion of women (51%) than men (38%). The 3 largest factors contributing to burnout among emergency medicine physicians were having too many bureaucratic tasks (51%), a lack of respect from patients (50%), and a lack of respect from administrators/employers, colleagues, or staff (46%).
Burnout in Family Medicine
Slightly more than one-half of female family physicians (51%) and one-third of male family physicians (33%) reported experiencing burnout. The overall proportion of respondents who said they felt burned out was 42%. Depression affected 4% of family medicine physicians, while 15% said they felt both burned out and depressed.
By far the largest contributor to family physician burnout was having too many bureaucratic tasks; 73% of respondents reported tasks such as paperwork and charting were the main culprit. Working too many hours and a lack of respect from administrators/employers, colleagues, or staff were cited as factors contributing to burnout by 36% and 31% of respondents, respectively.
Burnout in Pediatrics
Overall, 39% of pediatricians reported feeling burned out. More female pediatricians reported feeling burned out more than their male counterparts (46% vs 26%, respectively). The proportion of respondents who said they felt depressed was 3%, while 19% reported being both burned out and depressed.
The 3 largest contributors to burnout were having too many bureaucratic tasks (65%), lack of respect from administrators/employers, colleagues, or staff (40%), and spending too many hours at work (38%).
Burnout in Obstetrics and Gynecology
In Medscape’s 2023 report, obstetrics and gynecology physicians reported the following11:
38% felt burned out;
5% felt depressed; and
20% felt both burned out and depressed.
Obstetrics and gynecology physicians reported that the 3 largest contributors to their burnout were having too many bureaucratic tasks (56%), spending too many hours at work (47%), and a lack of respect from administrators/employers, colleagues, or staff (42%).
Burnout in Internal Medicine
Nearly half of female internists (49%) reported dealing with burnout, vs 31% of male internists. However, 4% of both male and female internists said they felt depressed, and 21% of both male and female internists said they felt both burned out and depressed.
Having too many bureaucratic tasks was the primary contributor to internist burnout (64%). Insufficient compensation/salary was the second-leading factor (40%), followed by a lack of respect from administrators/employers, colleagues, or staff (35%).
Physician Stress and Burnout: What Can Be Done?
Many of the factors known to contribute to burnout are systemic and need to be addressed by health care organizations. However, physicians can take action to limit their stress and prevent exhaustion. The following strategies may help mitigate burnout:
Optimizing physical health by exercising regularly, eating a healthy diet, and developing good sleep habits;
Employing stress management techniques, such as meditation and mindfulness exercises;
Making time to pursue other interests, hobbies, or relaxing activities that bring joy and satisfaction;
Setting healthy boundaries by limiting work hours and saying “no” or delegating tasks to preserve time and energy; and
Seeking physician burnout therapy or coaching to build new skills, learn how to properly set boundaries, and recognize additional burnout symptoms.
Note: This article originally appeared on Psychiatry Advisor
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