The president of the American Medical Association calls for "urgent action" to improve physician well-being.
The physician burnout level and other measures of physician distress have increased dramatically during the coronavirus pandemic, a new research article has found.
The researchers led by Tait Shanafelt, MD, chief wellness officer at Stanford Medicine, have measured physician burnout every three years since 2011. After measuring physician burnout in 2020, the researchers decided to measure the impact of the ongoing pandemic, conducting a survey from Dec. 9, 2021, to Jan. 24, 2022.
The findings of 2021 survey are troubling, with 62.8% of physicians reporting at least one symptom of burnout compared with 38.2% in 2020.
Yesterday, Jack Resneck Jr., MD, president of the American Medical Association, said the new findings are alarming.
"While the worst days of the COVID-19 pandemic are hopefully behind us, there is an urgent need to attend to physicians who put everything into our nation's response to COVID-19, too often at the expense of their own well-being. The sober findings from the new research demand urgent action as outlined in the AMA's Recovery Plan for America's Physicians, which focuses on supporting physicians, removing obstacles and burdens that interfere with patient care, and prioritizing physician well-being as essential requirements to achieving national health goals," he said in a prepared statement.
The new research article, which was published this week by Mayo Clinic Proceedings, features information collected from more than 2,400 physicians. In addition to the finding on increased physician burnout, the study includes several key data points.
- Mean emotional exhaustion scores among physicians increased 38.6% from 2020 to 2021
- Mean depersonalization scores increased 60.7% from 2020 to 2021
- Satisfaction with work-life integration decreased from 46.1% in 2020 to 30.2% in 2021
- The proportion of physicians with a favorable professional fulfillment score decreased from 40.0% in 2020 to 22.4% in 2021
- The proportion of physicians who reported they would choose to become a physician again if they could reconsider their career choice decreased from 72.2% in 2020 to 57.1% in 2021
- In a multivariable analysis of the 2021 data, being a woman (odds ratio 2.02), long work hours per week (odds ratio 1.02 for each additional hour), and practicing emergency medicine (odds ratio 4.59), family medicine (odds ratio 1.57), and general pediatrics (odds ratio 2.44) were linked to higher levels of burnout
- In a multivariable analysis of the 2021 data for work-life integration factors, being a woman (odds ratio 0.59) and long work hours per week (odds ratio 0.94 for each additional hour) were linked to lower odds of satisfaction with work-life balance
The data indicates a significant increase in physician distress between the 2020 and 2021 surveys, the research article's co-authors wrote. "The results show a large increase in mean emotional exhaustion and mean depersonalization scores, as well as the proportion of physicians with symptoms of burnout compared to both fall of 2020 and all prior assessment timepoints over the last decade. Mean scores for emotional exhaustion were 39% higher relative to the 2020 survey while mean depersonalization [scores] were 61% higher. The prevalence of burnout increased roughly 25% over the 12-month interval between the end of 2020 and the end of 2021. Satisfaction with [work-life integration] also declined over this interval."
Interpreting the data
The pandemic has had a disproportionately negative impact on female physicians, the study found. In a multivariable analysis that adjusted for personal characteristics such as age and professional characteristics such as practice setting, the odds ratio for burnout among female physicians compared to male physicians was 2.02 in 2021 compared to 1.27 in 2020. "These data suggests the long-documented increased risk for burnout and work-life conflict in women physicians has been exacerbated by the COVID-19 pandemic," the study's co-authors wrote.
The impact of the pandemic on physicians has broader ramifications for the entire healthcare system, the study's co-authors wrote. "The collective effect on the US physician workforce appears to be profound. Given the association of physician burnout with quality of care, medical errors, reductions in clinical work effort, turnover, departure from practice, and healthcare costs, these findings also have potentially critical implications for the US healthcare delivery system."
Rising to the challenge
Although the pandemic has prompted many healthcare organizations to acknowledge the essential role that their workforce has in providing high-quality and safe care, efforts to promote physician well-being are often inadequate, the study's co-authors wrote.
"While sincere, many of these organizations have focused on providing resources for individuals in distress, such as psychological first aid, peer support, mental health care, and counseling. These organizations will benefit from embracing a more expansive and holistic approach to prevent occupational distress rather than simply perpetually reacting to it by providing support to distressed clinicians. Such approaches require organizational commitment as well as dedicated leadership and include comprehensive and sustained approaches to reduce administrative burden, enhance team-based care, address inefficiency in the practice environment, and establish staffing models consistent with new models of care delivery."
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Physician burnout has spiked significantly during the coronavirus pandemic.
In survey data, mean emotional exhaustion scores among physicians increased 38.6% from 2020 to 2021.
Mean depersonalization scores increased 60.7% from 2020 to 2021.