This year's Medscape survey, echoing other recent national surveys, strongly suggests that burnout among US physicians has reached a critical level. Burnout in these surveys is defined as loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. In this year's Medscape report, the highest percentages of burnout occurred in critical care, urology, and emergency medicine, all at 55%. Family medicine and internal medicine follow closely at 54%. In last year's report, the highest percentages of burnout were also in critical care (53%) and emergency medicine (52%). Of note, however, burnout rates for all specialties are higher this year. The 2015 survey published in the Mayo Clinic Proceedings compared burnout between 2011 and 2014 and observed an increase in the percentage of physicians reporting at least one burnout symptom, from 45.5% to 54.4%. Physicians 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 the physicians reporting burnout, critical care had the highest average severity rating at 4.7, whereas those with the lowest burnout ratings were rheumatologists and psychiatrists (3.9). It should be noted, however, that just as the percentages of burnout have increased among all physicians compared with last year's Medscape Lifestyle Report, so have the severity ratings. Dear Doctor: Are You Stressed Out? Physicians were asked to rate causes of burnout on a scale of 1-7, where 1 equals "Does not contribute at all" and 7 equals "Significantly contributes." Top on the list, with an average rating of 4.8, was having too many bureaucratic tasks, followed by too many work hours (4.1) and increasing computerization at 4.0. These were the top three causes last year as well, but the rankings were slightly lower (4.7, 4.0, and 3.7, respectively). This year, the survey added the option "maintenance of certification requirements," which was tied for fifth place with "feeling like a cog in a wheel" as a cause of burnout. Many physicians commented anecdotally on this question, adding some further factors that contributed to burnout. By far, the most frequently noted were insurance issues. Other often-mentioned causes were threat of malpractice, the change to the 10th edition of the International Classification of Diseases (ICD-10), and lack of patient respect and appreciation. Many physicians also added family stress as a factor. Source
