January 16, 2019 / 4:43 PM / 5 months ago

No quick fix for physician burnout, depression

NEW YORK (Reuters Health) - Close to 44 percent of U.S. physicians are burned out, and 15 percent are depressed and thinking about suicide, according to a survey conducted by Medscape.

More than one doctor per day commits suicide - a rate higher than in any other profession and more than twice that of the general population, Medscape reports.

The findings come as no surprise to Dr. Carter Lebares, Director of the Center for Mindfulness in Surgery at the University of California, San Francisco, who has studied burnout among surgical residents but was not involved in the survey.

“There is a passionate argument surrounding the data and discourse about who’s to blame for this situation,” Lebares told Reuters Health in an email. “Quotes from respondents in the Medscape survey capture this very poignantly: anger over a broken system, loss of time with patients, being asked to sacrifice dwindling personal time to ‘fix ourselves,’ and demoralization that the only way out is to quit or severely curtail our work.”

The Medscape survey found that male physicians are more likely to cope with burnout by exercising (51 percent males vs. 43 percent females), whereas female physicians are more likely to talk with friends and family (52 percent females vs. 37 percent males). More women eat junk food to cope (38 percent vs. 27 percent) and similar percentages of men and women drink alcohol (23 percent men; 21 percent women).

"The approach we promote and champion in our research and programming for surgeons includes cognitive training for stress reduction through mindful meditation training (bit.ly/2FDinr6); learning skills for advocacy; and engaging the institution to address broader change," Lebares noted.

The Medscape survey pinpointed too many administrative tasks as a leading cause of physician burnout (59 percent), as well as spending too many hours at work (34 percent). Other factors included electronic health records (32 percent), insufficient compensation/reimbursement (29 percent) and “feeling like just a cog in a wheel” (20 percent).

“Data are coming to suggest that an institutionally supported network of choices for wellbeing will be the answer - some combination of things like limited EHR time, increased ratio of patient time, better food choices at work and home, room for personal health (like exercise breaks), tailored mindfulness-based interventions, financial planning services or untraditionally structured jobs,” Lebares said.

Although the survey did not ask how burnout might affect patient care, “we did ask how depression affects (it),” Leslie Kane, Senior Director of Medscape Business of Medicine told Reuters Health by email. “Fourteen percent of physicians said they made errors they might not ordinarily make; 16 percent are more apt to express frustration in front of the patient; and 26 percent say they are less motivated to be careful taking patient notes.”

Depression also affects physicians’ dealings with colleagues or staff, with 47 percent stating that they are more easily exasperated with staff/peers, and 40 percent stating they express their frustration in front of their colleagues.

Yet 64 percent of respondents said they don’t plan to seek help for depression or burnout and they have not sought help in the past.

Comments in the survey suggest that some physicians are retiring earlier because of burnout or depression.

“The fact that physicians are retiring earlier may exacerbate the physician shortage that appears to exist,” Kane said. “In years past, physicians who ‘retired’ often worked part time or kept a small patient base. However, with high malpractice premiums, rules and regulations, and the stress and aggravation that physicians experience, they are often more likely to just want out.”

For this report, Medscape surveyed more than 15,000 physicians across more than 29 specialties across the U.S.

SOURCE: wb.md/2FGWNSi Medscape, online January 16, 2019.

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