Some professions are intrinsically more demanding than others.
Among the most stressful ones are those that involve human contact and rapid decision-making skills that can have a serious impact - be it social, financial, or elsewhere. Healthcare professions squarely fall under this category.
According to Health Psychology Research, healthcare professions are among the top six most stressful occupations. At the forefront of this group of professionals are physicians, who face an incredible amount of pressure on a daily basis. In addition to shouldering administrative burdens, they are expected to meet the everyday increasing patient demand while familiarizing themselves with emerging technologies. Sooner or later, they are likely to experience what is known as physician burnout.
A recent paper published by the Massachusetts Medical Society cites that 78% of physicians surveyed in a previous study said that they experience some symptoms of professional burnout. It’s predicted that by 2025, the U.S. will have a nationwide shortage of approximately 90,000 physicians, many driven out of practice or from medicine due to the effects of burnout.
In this article, we explore the issue in greater detail, including:
- The causes of physician burnout.
- Signs and symptoms of physician.
- Physician burnout by medical specialty.
- How to avoid physician burnout in the first place.
Let's dive in.
What is physician burnout?
Physician burnout is the state of physical, mental, and emotional exhaustion brought about by long term involvement in an emotionally challenging situation in the line of duty. It is also commonly referred to as physicians work-related syndrome.
What causes physician burnout?
According to a 2019 Medscape survey, 60% of respondents cited “too many bureaucratic tasks,” such as charting and paperwork, as the number one cause of physician burnout. 34% of respondents said that spending too many hours at work was the cause of burnout, with almost 50% of physicians working at least 60 hours per week.
Other causes of physician burnout include:
The nature of medical practice
The healthcare profession is inherently a stressful job for the simple reason that physicians deal with sick, injured, scared, and/or dying patients and their families. Even on the best of day, their work is significantly taxing.
It should come as no surprise that physicians who work in public hospitals or other healthcare facilities that receive lots of patients are at greater risk for burnout than those who serve fewer patients. Physicians who also take on multiple responsibilities or those that don’t have medical assistants are also more likely to experience burnout.
Working too many hours
If you work too many hours or take night and weekend calls in addition to your normal hours, you are at an increased risk of experiencing physician burnout. In fact, the odds of burnout increase by 3 percent with each additional hour you work per week.
Leadership skills of supervisors
The stress levels of employees are strongly influenced by the leadership skills of their immediate supervisors. Physicians are not immune to this fact. Studies reveal a direct link between the physician burnout and poor leadership. Working under an unskilled, or worse, absent boss, is puts you at a great risk for physician burnout.
Pressure to practice defensive medicine
A wrongful suit made by a patient can cause great harm, stress, and embarrassment to a physician --- both financially and psychologically. With the number of malpractice suits against physicians on the rise, many feel obligated to practice defensive medicine. The pressure that comes with having to make decisions based on the possible need to defend themselves and the overthinking it involves can contribute physician burnout over time. Of course, this underscores the importance of medical malpractice insurance.
Less meaningful relationships with patients
As physicians rise through the professional ranks, their workloads follow suit. Oftentimes this means you can no longer spend as much time engaging and communicate with your patients like you previously did. Unfortunately, this "cut-to-the-chase" mentality may end up damaging relationships that took years to build. As more and more patient relationships begin to dissolve, human interaction for physicians flatlines - and the likelihood of burnout increases.
A decline in patient loyalty
As relationships between doctors and the people they treat become less meaningful, patient loyalty takes a hit. And this is a big deal. For most physicians, the motivation to practice medicine goes beyond the paycheck. Patient approval justifies your hard work, as well as how you spend your very valuable time. With emerging technologies disrupting healthcare for better and worse at every turn, this brings about an absence of personal touch.
Student loan debt
Pursuing a career in medicine is quite expensive. Upon enter professional practice, most physicians are left with hundreds of thousands of dollars in student loan debt. The burden of paying off these loans undoubtedly brings about extreme financial strain to the young physicians. Although there is no instant remedy, refinancing medical school loans can signficantly lessen the financial burden.
Signs and symptoms of physician burnout
Physician burnout doesn't just spring up overnight. It's often a slow, steady decline with plenty of warning signs along the way.
Here are some common symptoms that are consistently associated with physician burnout:
- Exhaustion: Energy depletion feelings set in and you tend to feel drained on the spirit, emotion and energy levels.
- Lack of effectiveness: You begin to question whether your work really impacts other’s lives.
- Cynicism: This is when you feel detached from patients, work and co-workers both emotionally and mentally and feel the urge to complain about everything.
While these are certainly not the only side effects of burnout, they are major red flags to keep an eye out for.
Physician burnout by specialty
Within the field of medicine itself, there some areas that have proven to be more stressful than others.
So, what are the most stressful medical specialties? To date, the highest percentage of physician burnout is experienced in the following medical specialties:
- Urology - 54%
- Neurology - 53%
- Physical medicine and rehabilitation -52%
- Internal medicine – 49%
- Emergency medicine – 48%
- Family medicine – 48%
What about the least stressful medical specialties? The lowest physician burnout rates were recorded in these medical specialties:
- Public health and preventive medicine – 28%
- Nephrology – 33%
- Pathology – 33%
- Ophthalmology – 34%
- Otolaryngology – 36%
- Plastic surgery - 36%
Of course, as we know by now there are many factors that contribute to physician burnout. The level of stress associated with a particular specialty doesn't automatically mean its practitioners are at a higher risk. Still, it's definitely worth taking into consideration.
How to avoid physician burnout
Physician burnout is a well-document issue in the medical field. So of course, there are ideas, practices, and strategies to help steer clear of it.
Something as simple as hiring a great assistant can help physicians avoid burnout. These assistants can help to enter patient’s data records to save doctors time for a longer face to face stretch with patients. The more menial tasks you can take off your plate, the better.
Make time for a release
Everyone needs a healthy way to unwind after a long day of work. As a physician, it's imperative that you make personal time for yourself and spend it away from work. Whether that means finding a hobby, playing sports, or simply watching your favorite TV show, finding time to relax outside of work will help you refresh your mind and body.
Not only is exercise a great way to alleviate stress, but it also the positive, healthy release like we discussed above. Regular exercise is known to help increase overall productivity. Better yet, exercise helps you get a good night sleep. And well all know adequate sleep is key to renewed energy. So practice what you preach, right?
Find a support system
Some patients will drain you emotionally as they are difficult for one reason or another. Try sharing your feelings with a trusted friend, mentor, colleague, or someone who can offer you emotional support.
Use social media as a community
It may seem unorthodox, but it can be a great way for you to connect with other doctors who you may not otherwise see in person. This is very efficient especially if you’re working in a smaller practice or solo. And you're not limited to the usual suspects, like Facebook and Twitter. Nowadays, exclusive doctor networks allow medical professionals to connect like never before.
Reports reveal that 80% of healthcare organizations believe physician burnout is a problem.
It negatively impacts the physician’s productivity and quality of life, as well as the quality of care, patient satisfaction and safety.
Even though there are organizational factors that influence physician satisfaction, addressing the impact of physician burnout on an individual level is an important step.