Because of our work at The Happy MD with stressed-out and burned-out physicians, it has been clear to us that burnout rates for physicians in the U.S. have been rising in the last several years. There is just too much political chaos, marketplace M&A activity, and documentation overload for it to be otherwise.
Finally, the research has caught up with our suspicions. The Mayo Clinic published results of their second survey of burnout in physicians compared to those of non-physician workers in the December 2015 issue of the Mayo Clinic Proceedings. The first study, published in 2011 was major news across the country. It was also the first study that compared physician burnout rates to a “normal population”.
What did the study show?
Here are the headline statistics:
54.4% of physicians admitted to at least one symptom of burnout in 2014
This is up from 45.5% in 2011—a 19.5% increase. The Maslach Burnout Inventory was used to measure burnout in both groups; emotional exhaustion was the most common physician burnout symptom.
Burnout in the “normal population” stayed steady over that time period at about 25%
The odds ratio shows physicians are 1.97 times more likely to suffer from burnout than the normal population.
Thirty-nine percent (39%) of the physicians screened positive for depression
It is surprising that this failed to gain much attention; it may have slipped under the radar because this rate did not change between the studies. You have to dig deeper into the report to find this statistic.
The rate of “suicidal ideation in the past year” among the physicians jumped from 4.0% to 7.2%
That is an 80% increase! Seven point two percent (7.2%) of physicians had thought about suicide. This is the shocker of the report for me.
Work Life Balance continues to worsen
How was the study conducted?
A database of 94,032 physicians was assembled via the American Medical Association Physician Masterfile. Physician Burnout surveys were delivered by email in August 2014 with three reminder emails delivered over the ensuing 6 weeks.
Thirty-five thousand nine hundred and twenty-two (35,922) physicians who opened at least one invitation e-mail were considered to have received the invitation to participate in the study. Of those, 6880 or 19.2% filled out the survey. This response rate is about average for surveys of this type. There is no data on how the non-responding 80% would have filled out the survey. All we know is this population of responders is a statistically valid sample of the larger population with regards to demographics.
To obtain the “normal population”, the researchers surveyed a database of 5,392 employed individuals ages 35-65 maintained by the Knowledge Panel.
Both populations were screened for
- Depression and suicidal ideation
- Satisfaction with work-life balance
Take home points
From my work with thousands of burned out physicians and dozens of the organizations that employ them, here are the points I would like you to take away from this post:
- Physician burnout is bad and getting slowly worse.
- The burnout prevalence in your organization is probably right around 50% too—no matter how much you might wish that were not true. And, unless you have a proactive, system-wide burnout prevention program in place, your burnout rate may actually be higher than this.
- It does not have to be this way. Our experience with hundreds of physicians participating in all specialties has shown us that simple changes in awareness and new actions applied over time can reverse and prevent burnout. There is no rocket science or black box of mystery here. We need to fill in the holes in our medical education and be actively involved in building a less stressful workplace.
- Suicidal ideation is surprisingly common; that is the really scary statistic here. This is why we always recommend a 24/7 physician crisis hotline and a proactive crisis intervention program for all organizations that employ physicians. This service must be well promoted and highly visible in order to garner participation from the doctors.
- Despite the constant presence of burnout concerns in the healthcare industry and the exploding popularity of the topic of physician burnout, effective prevention tools are not being disseminated widely enough to affect the trend of increasing physician burnout rates.
Even though it is our mission to:
“Revolutionize the quality of healthcare by improving the health, happiness, humanity and effectiveness of the providers in the system.”
- We have not yet reached nearly enough doctors given the size of the problem.
This level of physician burnout interferes with our ability to offer quality of care, however, that is not my main concern as a change agent. My concern is this level of burnout makes it extremely challenging for doctors to pull their heads up and play a meaningful role in the redesign of the workplace necessary to reverse this trend.
Continued prevalence studies are meaningless here. Please stop! It is time for action to treat and prevent physician burnout, rather than continue to run simple studies like this to pad your bibliography. Sheesh. I wish the academics would do the hard work of measuring effectiveness of prevention efforts with the same vigor as they complete these simple survey studies.