Nearly half of U.S. doctors struggling with burnout

NEW YORK Mon Aug 20, 2012 4:11pm EDT

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NEW YORK (Reuters Health) - Job burnout strikes doctors more often than it does other employed Americans, according to a national survey out Monday.

More than four in 10 physicians across the nation said they were emotionally exhausted or felt a high degree of cynicism, or "depersonalization," toward their patients, researchers found.

"This high rate of burnout has consequences not only for the individual physicians, but also for the patients they are caring for," said Dr. Tait Shanafelt of the Mayo Clinic in Rochester, Minnesota, who led the research.

Previous studies have shown burned-out doctors are more prone to thinking about suicide and to making medical errors than are their peers, Shanafelt added.

The survey, published in the Archives of Internal Medicine, is the first to evaluate burnout rates nationally across different medical specialties. It includes nearly 7,300 doctors who filled in questionnaires about their work-life balance in 2011.

Thirty-eight percent had high emotional exhaustion scores, which is akin to losing enthusiasm for their job, according to Shanafelt; 30 percent had high depersonalization scores, which translates into viewing patients more like objects than human beings; and 46 percent had at least one of the two symptoms.

The researchers also compared physicians with a random sample of 3,400 employed Americans without an MD. Based on a modified version of the original questionnaire, 38 percent of the doctors had burnout symptoms versus 28 percent of the rest.

And although education beyond high school was generally linked to less burnout, that didn't hold true for doctors.

"This study advances our knowledge by, for the first time, comparing to the general population and showing that physicians are at higher risk of burnout," said Dr. James Wright, chief surgeon at The Hospital for Sick Children in Toronto.

"It's very clear that when physicians are becoming burned-out it begins to affect their relationships with other healthcare workers and with patient families," Wright, who has studied the issue but was not part of the new work, told Reuters Health.

His hospital does yearly employee surveys to guide staff with worrisome symptoms toward resources that can help them find a better work-life balance.

It's not clear why burnout strikes so many doctors, said Shanafelt, adding that excessive workloads are only part of the equation. Other possible reasons include too much paperwork, loss of professional autonomy and a higher patient load to make up for declining reimbursement rates.

"There is a sense that the volume of patients that need to be seen is increasing and it's taking away some of the time needed to build a relationship and give the best care possible," Shanafelt told Reuters Health. "That starts to build cynicism, I think."

The new results come with some uncertainty, because only about a quarter of the doctors who received an invitation to participate in the survey completed the questionnaires.

Burnout was most common among doctors at the "frontline of care," such as those working in the emergency room or in family medicine, whereas dermatologists and preventive care specialists were less affected.

Shanafelt worried that as more and more people get health insurance under President Obama's Affordable Care Act, the pressure on primary care providers would increase "at a time where those individuals are already quite stretched."

SOURCE: bit.ly/KEPNSw Archives of Internal Medicine, online August 20, 2012.

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