Responses to a new Medscape survey indicate that 44% of physicians meet the criteria for burnout, up from 42% in last year's report. In addition, 11% are colloquially depressed (feeling down or sad), and 4% are clinically depressed, according to the Medscape National Physician Burnout, Depression & Suicide Report 2019. The responses show that 14% have had thoughts of suicide but have not attempted it, and 6% said they preferred not to answer. Survey authors note that one physician a day dies by suicide, the highest rate of any profession. According to this survey, 1% of physicians have attempted it. Medscape members and nonmembers were asked to take the online survey; 15,069 physicians across 29 specialties completed it from July 27 through October 16, 2018. Most Who Are Considering Suicide Tell Someone Most who have had thoughts of suicide (58%) tell someone, and that person is most often a therapist (34%) or a family member (33%), the responses indicate. By specialty, urologists reported the highest percentage of burned-out physicians (54%), followed closely by neurologists (53%). Physicians in public health and preventive medicine saw the least, at 28%. Last year, critical care physicians and neurologists had the highest burnout rates, at 48% each. Urologists also had the second-highest percentage (76%) of physicians who work more than 51 hours in the survey. Only general surgeons had more, at 77%. More Women Than Men Report Burnout Women had much higher burnout rates in the survey (50% vs 39% for their male counterparts). Several things may explain that, said Carol Bernstein, MD, a psychiatrist at New York University's Langone Medical Center. Among them are that women typically are more likely to admit the problem and that women bear disproportionately more child care and household responsibilities. One female family physician experiencing burnout who responded to the survey said, "I'm having medical problems as a result, having recurrent miscarriages." Others gave examples of other side effects. An anesthesiologist said that as a result of burnout, "I'm drinking more and have become less active." "My relationships have withered...my family is frustrated," a general surgeon wrote. "We rarely make plans to do anything socially as they are likely to be canceled." Most Point to Administrative Tasks When asked what leads to burnout in their lives, 59% of physicians said too many administrative tasks. The next most common answer was spending too much time at work (34%) and increased computerization of practice, such as the use of electronic health records (EHRs) (32%). An internist wrote, "Burnout is mostly due to lack of sleep because the EHR takes so much time. I used to be able to chart on a patient in 5-10 minutes for established patients. Now it takes 20-40 minutes to chart on an established patient." Burnout numbers were similar across practice settings, whether in healthcare organizations, hospitals, outpatient clinics, or in academic settings. Prevalence fell between 42% and 49% in those settings. The prevalence of burnout among solo practitioners was only slightly lower, at 41%. Coping With Burnout When asked how they cope with burnout, physicians' top answer was exercise (48%), followed by talking with family and friends (43%) and isolating themselves (41%). Those who reported depression were asked whether it affects their patient care, and 53% said it did. More than one quarter (26%) said it makes them less motivated to take careful and thorough patient notes, and 14% said it has led them to make errors they might otherwise not have made. Of those reporting burnout or depression, only 16% said they are seeking help or plan to; 64% said they will not seek help and have not done so in the past. By specialty, psychiatrists and those in public health/preventive medicine were the most likely to seek help (45%). The survey slideshow author writes, "Notably, of those least likely to seek help were three groups among the top five with the longest hours: surgeons [17%], nephrologists [19%] and urologists [20%]." Which Specialists Are Happiest at Work? The survey also asked about those on the flip side — the happiest. Plastic surgeons were at the top (41%), followed by those in public health/preventive medicine (40%) and ophthalmologists (39%). Least happy were those in physical medicine and rehabilitation (19%) and emergency and internal medicine (both at 21%). Source
