Forty-two percent of physicians said they feel burned out, while 15% reported feeling depressed, according to a new Medscape survey.
Half of those who reported burnout experienced those feelings on a regular basis. Of the smaller number of physicians who reported depression, 70% called it “colloquial,” while 19% said they had clinical depression.
Those reporting to be the happiest at work were ophthalmologists, orthopedists, plastic surgeons, and pathologists. Those who were the least happy included clinicians in diabetes and endocrinology; family medicine; critical care; internal medicine; and, at the bottom, cardiology. Some 15,000 physicians from 29 specialties participated in the Medscape survey.
Burnout was reported at the highest rates by critical care physicians (48%), neurologists (48%), and family medicine doctors (47%). In a large number of specialties, 40% or more of the respondents said they felt burned out. Among oncologists, 39% reported burnout. Lower numbers — but still somewhat large — of orthopedic physicians (34%), ophthalmologists (33%), pathologists (32%), and dermatologists (32%) said they were burned out.
The smallest number of clinicians who said they were burned out were plastic surgeons, with just 23% reporting that feeling.
Medscape also asked whether physicians felt both burnout and depression. Ob/gyns were the leaders, with 20% saying they felt both. Specialists in public health and preventive medicine, urology, neurology, and family medicine followed. At the bottom, just 8% of psychiatrists said they were both burned out and depressed.
Women tended to report feeling burned out more than men. Mid-career physicians also seemed to be hit the hardest, with half of those aged 45 to 54 reporting burnout.
For those who said they felt depressed, the job was the biggest contributing factor, approaching a 6 on a 7-point scale used by Medscape. Finances followed, at around 4, with health considered the least important factor in depression.
Too much bureaucracy and paperwork was the main factor contributing to burnout, listed by 56% of respondents. Spending too much time at work, and lack of respect — from colleagues, administrators, or staff — took the second and third spots.
Government regulations, decreasing reimbursement, emphasis on profit over patients, and maintenance of certification requirements were all also listed as burnout factors, but were less important, with only about 15% to 16% of respondents citing those.
Disconnect on Perceived Impact on Care
Medscape asked physicians who reported feeling depressed whether their depression had any impact on patient care. Some 40% said it did not affect their interaction with patients.
However, about a third said they were less engaging, more exasperated, and less friendly with patients because of their depression. Fourteen percent of respondents said they make errors that might not otherwise occur.
A larger number seemed to recognize that their distress was affecting interactions with staff and colleagues. Forty-two percent admitted to being less engaged with or actively listening to staff and peers. An equal number acknowledged being more easily exasperated, and a slightly smaller percentage said they were less friendly and that they expressed frustration in front of colleagues and staff.
Coping With Burnout
Survey respondents were also asked about what might reduce their burnout, what kinds of coping strategies they employ, including whether they might seek professional help, and whether their workplace offered any sort of assistance in dealing with burnout.
The most popular coping mechanisms were exercise — cited by 50% overall, with slightly more men than women favoring that — and talking with family and friends. More women than men said they turned to friends or family. Sleeping and isolating themselves from others were also much employed, as was listening to music. A third said they would eat junk food, and a fifth turned to alcohol. Few clinicians — less than 3% — said they used prescription drugs or marijuana to cope.
Similarly, a small number of survey respondents said they currently were receiving professional help or planned to do so. Sixty-six percent of men and 58% of women said they were not receiving counseling and had not done so in the past. Not surprisingly, the specialists most likely to seek help were psychiatrists, followed by plastic surgeons. At the bottom, 17% of cardiologists said they would be likely to do so.
Nonhospital academic practices, healthcare organizations, and hospitals were most likely to offer a workplace program to help. Office-based single specialty and solo practices were least likely. Only 10% of respondents from single practices said that a program was place. Interestingly, the highest number of clinicians who said they had used such a program were in office-based solo practices.
Some of the respondents had advice for colleagues on how to avoid burnout, including finding a way to make themselves happy on the job. Another suggested leaving the laptop at the office. “Stay at work until 6:00 pm if need be to finish your work, but when you go home, BE at home,” the respondent said.
Said another respondent, “Count your blessings.”
Respondents, who were recruited for the survey from July to October 2017, were required to be practicing medicine in the United States. The margin for error was ±0.79%, with a 95% confidence level using a point estimate of 50%.
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