Skip to main content

Physician Burnout Pervasive: 1 in 2 Internists Affected

 |  By cclark@healthleadersmedia.com  
   August 21, 2012

Physicians are more likely to be burned out and dissatisfied with life than workers in other professions, more stressed than other workers of similar education levels, and ED doctors, internal medicine specialists, and neurologists are the most burned out of all.

>>>
That's according to a study published Monday in the Archives of Internal Medicine that is the first to use a recognized scientific survey to compare levels of burnout and exhaustion among 24 physician specialty groups.

For example, 65% of emergency room doctors, 55% of internists, and 52% of neurologists indicated they were burned out. The study found 45% of general surgeons, 40% of neurosurgeons, 32% of dermatologists, and 30% of preventive or occupational or environmental medicine practitioners indicated burnout.

Among other specialty practices, family medicine doctors reported 50% burnout rates, otolaryngologists, orthopedic surgeons, anesthesiologists, obstetrician/gynecologists, radiologists and physical medicine specialists reported between 46% and 50%.

Of 7,288 physicians who responded to the survey, 37.9% had symptoms of burnout and 40.2% were dissatisfied with their work-life balance. Among 3,442 working U.S. adults, 27.8% responded they were burned out and 23.2% dissatisfied with their work-life balance.

>>>
The doctors and other U.S. workers were asked in June, 2011 to respond to these two questions on a frequency scale from "never" to "every day": 
  • How often do you feel burned out from your work?
  • How often do you feel you have become more callous toward people?

Colin West, MD, an internist at the of the Mayo Clinic Division of Health Sciences Research and an author of the report, said that his fellow researchers don't know why emergency doctors, primary care physicians, and neurologists seem to be faring worse, or why doctors seem more stressed out than the general population.

But they have some theories.

"These are the specialists that are on the front lines of care, the first contact for all comers," West says. "They're not able to focus or define their medical practice specifically or narrowly...It's difficult for them to be prepared for what comes next."

But perhaps more influential is the amount of paperwork and bureaucratic functions that are now falling disproportionately on certain types of doctors, West continues. "They have to spend a lot more effort, time and energy dealing with aspects of medicine that aren't really why they got into it in the first place."

He characterized the burnout sensation as one of "emotional exhaustion, a feeling of being overwhelmingly weary, like you're at the end of your rope. They say they're having a hard time seeing other people as people, rather as objects and become more callous, and for a physician, that's an awful thing."

Ryan Stanton, MD, a spokesman for the American College of Emergency Physicians and medical director of the ED at Good Samaritan Hospital in Lexington, KY, blamed high stress and shift turnover, as well as reduced compensation as reasons why emergency physicians are at the top of the burnout list.

"It used to be that the physician was put on a pedestal, a Norman Rockwell painting, a savior. But expectations of physicians continues to go up, yet compensation and assistance is going down," he says. "We're expected to do more and more and more. I'm four years out of residency and have been a physician for 10 years, but I can see myself getting burned out in the next five or six years." 

He began thinking twice, he says, when a patient slapped him for not giving someone pain medication, and he was recently "punched and kicked" by a patient in the ED, a patient who he'd treated many times, but who had never paid his bills.

Asked if he wasn't trained to expect that in an emergency room setting, he said, no. "You were always taught that Medicare, Medicaid, and insurance companies would pay you a fair amount." Now regulations and insurance companies and legislation – "everyone seems to be coming down on us," he says.

David Bronson, MD, president of the American College of Physicians, says the study represents "a call to action to address the issues that are driving doctors away. Internal medicine is a great life and a great career."

"But the main reasons internists are dissatisfied and burned out has to do with reimbursement and limits on how much time they can see patients.

"Practice hassles and paperwork, are a lot greater than they were," Bronson says. But he sees a "glimmer of hope" in new payment models specified in the Patient Protection and Affordable Care Act.

"The patient-centered medical home model, if administered properly and done in the way it should, will bring rewards back to medicine," he says.

West says the study findings produced a kind of "fear factor" among himself and his co-authors. "None of us think it's acceptable that nearly half of the physicians across the country might be suffering from burnout. It can't be good for patient care or the health of the profession. And it's very concerning that these burnout problems could get worse.

How to prevent the problem from worsening, and dissuading more students from choosing medicine for a career and in pushing older doctors to retire early or go into non-clinical medical professions is the challenge, West says.

He says that he and his co-authors feel strongly that numerous segments of society need to accept responsibility to fix the practice of medicine, from academic teaching institutions, to administrators, to those who impose paperwork requirements that doctors see as overwhelming.

"We need to figure out better ways to help physicians remember why they got into medicine in the first place, and to understand that the (mantra of the) culture of medicine that we're all invincible is flawed. We all need to understand that physicians are human.


See Also:

4 Strategies for Fed-Up Physicians
1 in 3 Physicians Plans to Quit Within 10 Years
Hospital Infections Linked to Burned Out Nurses
Don't Underestimate Damage Caused by Burned Out Nurses



Tagged Under:


Get the latest on healthcare leadership in your inbox.