Physician Burnout Eases, But Much Work Remains to be Done

Researchers document improvement in physician burnout from 2014 to 2017, but they find clinicians are at significantly higher risk than other members of the U.S. workforce.

Physician burnout and physician satisfaction with work-life integration improved from 2014 to 2017, recent research shows.

Over the past seven years, there have been several nationwide efforts to address physician burnout, which has been linked to physician involvement in patient safety incidents, unprofessionalism, and lower patient satisfaction. The efforts to curb physician burnout have included American Medical Association conferences and initiatives to create online resources.

The co-authors of the recent research, which was published in Mayo Clinic Proceedings, say improvement in physician burnout and work-life integration is promising, but more progress is needed.

"The current prevalence of burnout among U.S. physicians appears to be lower than in 2014 and near 2011 levels. This trend is encouraging and suggests improvement is possible despite the numerous contributing factors and complexity of the problem. Although the improvement is good news, symptoms of burnout remain a pervasive problem, and its prevalence among physicians continues to be markedly higher than in the general U.S. working population," the researchers wrote.

Physician burnout by the numbers
 

The researchers have assessed the prevalence of physician burnout in 2011, 2014, and 2017. The primary metrics used in the assessments are the emotional exhaustion and depersonalization measures of the Maslach Burnout Inventory.

The researchers generated several key data points:

• In 2017, 43.9% of physicians reported at least one symptom of burnout. This prevalence of burnout is significantly lower than the 54.4% level reported in 2014 and on par with the 45.5% level reported in 2011.
   
• In 2017, 42.7% of physicians reported satisfaction with work-life integration. This prevalence of work-life integration satisfaction is better than the 40.9% level reported in 2014 but worse than the 48.5% level reported in 2011.
   
• In 2017, physicians were more likely to be at risk for burnout compared to other U.S. workers (odds ratio 1.39). Physicians were also less likely to be satisfied with work-life integration compared to other U.S. workers (odds ratio 0.77).
   
• From 2011 to 2017, there has been a steady increase in the percentage of physicians screening positive for depression: 38.2% in 2011, 39.8% in 2014, and 41.7% in 2017.

"Burnout and satisfaction with work-life integration among U.S. physicians improved between 2014 and 2017, with burnout currently near 2011 levels. Physicians remain at increased risk for burnout relative to workers in other fields. … Although the change in burnout is favorable, symptoms of depression among physicians have continued to worsen," the researchers wrote.

Possible causes of physician burnout reduction
 

The researchers say there are four likely factors that contributed to the lower level of burnout reported in 2017 compared to 2014.

1. Outlier year: In 2014, physicians faced several challenging working conditions, including hospital and physician group consolidation, new regulations, and heightened administrative burdens such as increasing demands to feed data into electronic medical record systems.

2. Attrition: There may have been fewer burned out physicians in 2017 because distressed physicians left the workforce or decreased their clinical effort.

3. Rising to the challenge: National healthcare organizations have launched several initiatives to ease physician burnout, including the Accreditation Council for Graduate Medical Education, American College of Physicians, American Medical Association, and Association of American Medical Colleges.

4. Fixing problems: Health systems, hospitals, and physician practices have taken actions to improve the practice environment such as boosting team-based care, implementing documentation assistance, and designing more efficient workflows. "These and other efforts to improve physician well-being have proven to be efficacious and should be recognized as potential contributors to the favorable trend," the researchers wrote.

Prescription for change
 

The researchers say future work to reduce physician burnout and increase satisfaction with work-life integration should be viewed as "an ongoing journey."

"A coordinated, systems-based approach at both the national and organizational levels that addresses the underlying drivers is the key to making progress.  Evidence indicates that both individual- and organization-focused interventions are effective and indeed complementary. A formal program to assess, design, coordinate, and lead efforts to reduce the occupational risk for burnout and cultivate professional well-being can help accelerate progress at the organization level," the researchers wrote.