Medscape Lifestyle Report 2017: Race and Ethnicity, Bias and Burnout Much research has gone into studying patient race and ethnicity and their effect on the care received. The recent Medscape Physician Lifestyle Survey asked physicians to identify their race and/or ethnicity in order to explore associations with patient care, behavior, and levels of happiness. The survey again posed questions from previous years about burnout, bias, and other lifestyle factors. More than 14,000 physicians from over 30 specialties responded and provided some surprising results. Dear Doctor: Are You Stressed Out? The Medscape survey once again asked about burnout among US physicians, which is defined in this and other major studies as a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment.[1] Burnout rates for all physician respondents have been trending up since 2013, the first year that Medscape asked about it, when the overall rate was 40%. This year it is 51%, over a 25% increase in just 4 years. A recent major survey supports these findings, reporting that burnout and satisfaction with work-life balance had worsened between 2011 and 2014, with more than half of physicians reporting burnout.[2] In this year's Medscape report, the highest percentages of burnout occurred among physicians practicing emergency medicine (59%), followed by ob/gyns (56%) and family physicians, internists, and infectious disease physicians (all at 55%). The top four are all physicians who deal directly with patients with a range of complex problems. In Medscape's 2015 and 2016 reports, emergency medicine physicians, family physicians, and internists were also within the top five. Not surprisingly, other research has found high burnout rates in these three professions.[1,3-5] Respondents were asked to rate the severity of their burnout on a scale of 1 to 7, where 1 equals "It does not interfere with my life" and 7 equals "It is so severe that I am thinking of leaving medicine altogether." Of note, emergency and primary care physicians—groups that are consistently at the top in reporting burnout—did not have the highest rates of burnout severity. Among physicians reporting burnout, urologists had the highest average severity rating (4.6), followed by otolaryngology and oncology (both at 4.5). Surprisingly, infectious disease physicians, who were within the top five for experiencing burnout, had the lowest severity rating (3.9). Physicians were asked to rate causes of their burnout on a scale of 1 to 7, where 1 equals "Does not contribute at all" and 7 equals "Significantly contributes." Topping the list, with an average rating of 5.3, was "too many bureaucratic tasks," followed by "spending too many hours at work," at 4.7. These two factors ranked highest the past two surveys as well. And the ratings have been trending up: In the previous report, they were 4.8 and 4.1, respectively, and in the one before that, they were 4.7 and 4.0. "Feeling like just a cog in a wheel" and electronic health records (EHRs) also rated high as causes of burnout this year (4.6 and 4.5, respectively). In an October 2016 Medscape roundtable discussing EHRs and burnout, one of the panelists, Robert W. Brenner, MD, said, "If [EHR requirements are] implemented without a change in the workflow in the office, too much data entry falls on the physician. That is what is adding to the huge burden." Because "insurance issues," "threat of malpractice," and "family stress" were mentioned frequently as important contributions to burnout in last year's write-in responses to this question, the options were added to our survey. They rated 4, 3.9, and 3.1, respectively. In this year's report, as in prior years', burnout was reported at a higher percentage by female physicians (55%) compared with their male peers (45%). Percentages have trended up for both men and women since this question was first asked by Medscape in 2013. That year, 45% of women and 37% of men reported burnout. However, burnout appears to be leveling off in both women and men. Source
