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The Most Burned-Out Doctors By Specialty

Discussion in 'General Discussion' started by The Good Doctor, Feb 23, 2021.

  1. The Good Doctor

    The Good Doctor Golden Member

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    Physician burnout is far from a new concept, but in recent years, we're seeing more headlines labeling it an “epidemic.”

    Last month, Medscape published the findings of its 2021 Physician Burnout & Suicide Report, which illustrated the prevalence and severity of the issue. The survey, completed by over 12,000 physicians in 29 specialties from August to November 2020, showed that roughly 42% of doctors report that they are burned out.

    While that figure is about the same as was reported in last year’s survey, the COVID-19 pandemic has altered the landscape in many ways. One-fifth of respondents reported that their burnout symptoms began after the beginning of the pandemic. Beyond that, the virus has led to a shift in the specialties that feel most burned out, and widened an extant gender gap in feelings of burnout.

    Here’s a look at what the survey revealed about the current state of doctor burnout—from who’s been affected the most to what physicians are doing about it.

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    Who is most vulnerable?

    While year-over-year burnout levels remained steady, pandemic burdens appear to have hit some specialties harder than others. Last year’s Medscape survey found that the top five specialties most affected by burnout were urology, neurology, nephrology, endocrinology, and family medicine. This year, however, critical care tops the list, for obvious reasons.

    Here are the top 5 most burned-out specialties, according to the Medscape report (ranked by percentage responding to the survey question):

    1. Critical Care (51%)

    2. Rheumatology (50%)

    3. Infectious Diseases (49%)

    4. Urology (49%)

    5. Pulmonary Medicine (48%)
    On the other end of the spectrum, according to the survey, here are the 5 least burned-out specialties:

    1. Public health & Preventive Medicine (35%)

    2. Radiology (36%)

    3. Diabetes & Endocrinology; Allergy & Immunology (39%)

    4. Gastroenterology; Anesthesiology (40%)

    5. Psychiatry; Physical Medicine & Rehabilitation (41%)
    The pandemic has also burned out women more than men, the report found. Female physicians have consistently reported higher rates of burnout than men—for example, Medscape’s 2013 survey found that 37% of male respondents reporting feeling burned out, compared with 45% of female respondents. This year’s survey showed that the gap has widened, with 36% of men reporting burnout, compared to 51% of women. It’s hypothesized that this is attributable to the added burdens of childcare, particularly during a pandemic when a lack of daycare and additional responsibilities like homeschooling create a perfect storm.

    The survey also uncovered startling statistics on how burnout impacts doctors. Those who reported generally feeling happy about their lives, for example, went from 69% before the pandemic started to roughly 49% now. Respondents listed stress, social distancing, and future uncertainty as factors contributing to declining happiness levels.

    Similarly, 71% of respondents reported that their burnout has a moderate or severe impact on their life; 10% said that this impact is severe enough for them to consider leaving the field of medicine.

    While an estimated 300 physicians commit suicide each year, Medscape’s survey revealed that the number of physicians who have attempted suicide could be far higher than this, with 1% of respondents reporting an attempt and 13% reporting having suicidal ideation.

    Contributing factors

    The findings of Medscape’s survey also confirmed what past studies have indicated as the top factors that contribute to burnout. 58% of respondents cited having too many bureaucratic tasks as the biggest stressor contributing to their burnout. The next four most-cited factors were working too many hours (37%), a perceived lack of respect from administration or staff (37%), insufficient compensation (32%), and a lack of autonomy (28%).

    When it comes to workplace issues, respondents overwhelmingly pointed to having a poor work/life balance and not getting paid enough as the most pressing problems that need to be addressed.

    How physicians respond to burnout

    Nearly half of survey respondents said they use exercise to cope with burnout. Around 43% channel their woes by talking it out with family members or friends, and others cited sleeping (39%) and listening to music (36%) as cool-down strategies. Those are some of the healthy coping mechanisms.

    More worryingly, 43% of respondents reported their primary coping strategy as isolating themselves from others. Furthermore, 35% reported eating more junk food, and 26% reported drinking alcohol as their coping mechanism.

    The survey’s findings weren’t all doom and gloom, though. Some respondents noted they had taken measures in the workplace to alleviate burnout. These actions included reducing work hours (28%), changing their work setting (21%), and making changes to workflow or staff to ease their workload (20%).

    While some studies have pointed to “wellness programs” as a way to reduce burnout, Medscape’s survey revealed that these aren’t always offered to physicians. Only 35% of the survey’s respondents said their workplace had a program like this, and 42% said they would be very unlikely to participate in such a program.

    Studies suggest such reluctance stems from feelings that these programs focus on individual problems to systemic or institutional problems, essentially offering a temporary solution to their symptoms, rather than addressing the underlying causes. It’s also related to physicians’ perceptions of their problems. According to the survey, of those experiencing burnout, 52% believed their symptoms are not severe enough to seek help, 46% felt they could deal with it without the help of a professional, and 40% reported simply being too busy to address the issues.

    These findings correlate with the conclusions of a recent article, published in Teaching and Learning in Medicine, which argued that many burnout interventions are aimed at individual actions, like practicing mindfulness, and that these have only proved marginally beneficial. Much like the conclusion of a 2019 review, published in Mayo Clinic Proceedings, the authors argue that the most effective interventions don’t put the work onto the physician. Instead, they improve workflow processes, optimize electronic health records, reduce clerical burdens and implement team-based care systems––in short, they address the underlying causes of burnout, rather than its symptoms.

    Whether doctor burnout is attributable to the pandemic, other pre-existing factors, or both, there are steps you can take to conquer it. Click here to learn more.

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