|September 2012 · Vol. 24, No. 9
Survey: Burnout is widespread among US physicians
Almost one in two US physicians has a symptom of burnout
A new survey confirms what many clinicians already know firsthand: Burnout is common among physicians in the United States. Almost half (45.8%) of a large sample of physicians (n = 7,288) reported at least one symptom of burnout, which included high emotional exhaustion (37.9%), a high level of depersonalization (29.4%), and a low sense of personal accomplishment (12.4%).1
Compared with a sample of working US adults (n = 3,442), physicians were more likely to report symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with their work-life balance (40.2% vs 23.2%).
These findings are disturbing because, as the investigators noted in their report, “burnout may erode professionalism, influence quality of care, increase the risk for medical errors, and promote early retirement. Burnout also seems to have adverse personal consequences for physicians, including contributions to broken relationships, problematic alcohol use, and suicidal ideation.”1
How ObGyns responded
Specialties reporting the highest level of burnout were emergency medicine, general internal medicine, neurology, and family medicine. Those with the lowest level of burnout were pathology, dermatology, general pediatrics, and preventive medicine.
The ObGyn specialty ranked near the top of the list in terms of burnout, with more than 45% of respondents reporting it. The specialty ranked near the bottom of the list (along with general surgery and general surgery subspecialties) in its level of satisfaction with work-life balance (just over 40%).
Some reasons for the high rate of burnout among ObGyns may be the need for extended call, low reimbursement for many procedures, and the high exposure to medicolegal risk among obstetricians.
When investigators analyzed data—adjusting for age, sex, relationship status, hours worked per week, and education—they found that burnout was less likely among physicians who were older and those who were married. The more hours worked per week, the greater the risk of burnout.
Education benefitted nonphysicians but tended to increase the likelihood of burnout among physicians. For example, compared with high school graduates, nonphysicians with higher levels of education had a lower risk of burnout (odds ratio [OR] for a bachelor’s degree, 0.80 [P = .048]; OR for a master’s degree, 0.71 [P = .01]; OR for a professional or doctoral degree other than an MD or DO degree, 0.64 [P = .04]). Among physicians, however, an MD or DO degree increased the risk of burnout (OR, 1.36; P <.001).
Data came from AMA Physician Masterfile
Investigators conducted their national survey of physicians in June 2011, with representation from all specialties. In addition, they surveyed a probability-based sample of the general US population for comparison.
The physician sample was compiled from data in the American Medical Association Physician Masterfile (PMF), “an almost complete record of all US physicians, independent of American Medical Association membership, that is primarily used for estimating the size of the physician workforce and for verifying professional credentials.”1
A systemic problem
In commenting on their findings, the authors suggested:
When considered with the mounting evidence that physician burnout adversely affects quality of care, these findings suggest a highly prevalent and systemic problem threatening the foundation of the US medical care system. The fact that almost 1 in 2 US physicians has symptoms of burnout implies that the origins of this problem are rooted in the environment and care delivery system rather than in the personal characteristics of a few susceptible individuals. Policy makers and health care organizations must address the problem of physician burnout for the sake of physicians and their patients.1
ObGyn Louis Weinstein, MD, agrees that the problem is pervasive. Dr. Weinstein has written extensively about the problems of burnout and physician shortages.2-4
“These issues were recognized in obstetrics and gynecology years ago, but nothing has been done to improve the situation by any of our professional organizations,” Dr. Weinstein says.
“The physician shortage is being addressed by an increase in the size of medical school classes and by the opening of several new medical schools,” Dr. Weinstein continues. “However, these strategies will not solve the epidemic of physician dissatisfaction. There is a very real shortage—which will continue to worsen—of working physicians, and new recruits to medicine will not be immune to the problems of burnout and dissatisfaction. The medical profession must recognize the need to develop and adopt newer models of practice (for example, the laborist model) that will improve physician well-being, decrease physician dissatisfaction, and markedly improve patient safety.”
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1. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. Published online August 20, 2012. doi:10.1001/archinternmed.2012.3199.
2. Weinstein L, Wolfe HM. The downward spiral of physician satisfaction—an attempt to avert a crisis within the medical profession. Obstet Gynecol. 2007;109(5):1181–1183.
3. Weinstein L. The perinatologist’s lament. Obstet Gynecol. 2008;111(5):1201.
4. Weinstein L. The unbearable unhappiness of the ObGyn: a crisis looms. OBG Manage. 2008;20(12):34–42.
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