We have long tended to view the medical profession as being glamorous — filled with status and prestige. However, the reality is that doctors seem to be struggling these days to feel satisfied and fulfilled, and many are turning to retirement.
Is it stress or burnout? The difference between stress and burnout is the ability to recover during down time.
The standardized questionnaire measuring three scales of physician burnout is called the Maslach Burnout Inventory (MBI). Physician burnout begins with the inability to recharge energy levels between call nights or days in the office.
The downward spiral has three distinct symptoms:
1. Physical and emotional exhaustion
- Feeling emotionally drained, depleted and worn out by work with an inability to recover during nonworking hours
2. Depersonalization
- Feeling negative, callous and cynical toward patients and their concerns
- Feeling sarcastic and pressured by patients
3. Reduced sense of personal accomplishment
- Viewing work negatively, without value or meaning
- Feeling incompetent
In 2012, a national survey reported that physicians in the United States suffer more burnout than other American workers, and the physician suicide rate is higher than in the general population.
The 2015 Medscape Physician Lifestyle Report noted that 46 percent of all physicians responded that they had burnout. This is a substantial increase since the 2013 Lifestyle Report, in which less than 40 percent of respondents reported burnout.
The prevalence of burnout in primary care physicians (PCPs) has increased over the past 10 years in Europe as well as in the U.S. Burnout rates ranged from 30 to 65 percent across specialties. The highest burnout rate was found among critical care (53 percent) and emergency medicine (52 percent).
Half of all family physicians, internists and general surgeons reported burnout. Among internists and family physicians, burnout rates rose from 43 percent in 2013 to 50 percent in both groups, an absolute increase of 7 percent but a 16 percent rise in incidence in just two years.
Those suffering the least burnout and the most happiness at work were dermatologists (37 percent), psychiatrists (38 percent) and pathologists (39 percent). National surveys report that female physicians have a 60 percent higher burnout rate than their male peers.
The most common causes of physician burnout include:
- Too many bureaucratic tasks that take critical time away from patient care
- Too many hours at work, impacting the work-life balance
- Insufficient income leading to minimal savings and unmanageable debt
- Increasing computerization, such as electronic health records (EHR) technology, which decreases face-to-face time with patients
- Impact of the Affordable Care Act (ACA)
- Gender, with females reporting more burnout because they tend to cope by focusing on stressful situations
- Age, with young physicians (35 years and under) in small specialties reporting highest rates
So, how do we reduce physician burnout? According to a number of studies, the practice of mindfulness appears to be a helpful approach. Mindfulness is mental training that enables one to attend to aspects of experience in a nonjudgmental, nonreactive way, which in turn helps cultivate clear thinking, equanimity, compassion and open-heartedness.
Physicians who attended a nonresidential weekend immersion and two short follow-up evening sessions experienced significant reductions in burnout, depression, anxiety and stress that were sustained at the study's conclusion nine months later.
Other than overthrowing the current order or starting a movement, it could be that expressing the thing that is most precious to them that has been lost. The opportunity to practice medicine in a way that is worthy of their dedication and lovemight be the first step in rescuing the profession and restoring the soul.
