US Physicians Suffer More Burnout Than Other Workers

August 22, 2012 — Physicians in the United States suffer from more burnout than other workers in the United States, new research shows.

A national survey of more than 7000 US physicians reveals that close to one half report having at least 1 symptom of burnout.

"The fact that almost 1 in 2 US physicians has symptoms of burnout implies that the origins of this problem are rooted in the environment and care delivery system rather than in the personal characteristics of a few susceptible individuals.

"Policy makers and health care organizations must address the problem of physician burnout for the sake of physicians and their patients," the authors, led by Tait D. Shanafelt, MD, Mayo Clinic, Rochester, Minnesota, write.

The survey findings were published online August 20 in the Archives of Internal Medicine.

First National Study

Extensive data on physician burnout have been published, but to the investigators' knowledge, no national study has yet evaluated rates of burnout among US physicians or explored differences in burnout by specialty.

Burnout among US physicians has also not been previously compared with burnout among US workers in other fields. Dr. Shanafelt and colleagues therefore conducted a national study of burnout among physicians from all specialties using the American Medical Association Physician Masterfile.

Responses from 7288 physicians were compared with those of a sample of 3442 working adults from the general population.

As assessed by the Maslach Burnout Inventory, 37.9% of surveyed physicians exhibited high levels of emotional exhaustion, and 29.4% showed evidence of a high level of depersonalization. In addition, 12.4% had a low sense of personal accomplishment.

Taken together, investigators found that 45.8% of physicians were experiencing at least 1 symptom of burnout, based on a high emotional exhaustion score or a high depersonalization score. More than 6000 of the physicians surveyed were also compared with 3442 control participants who were working in the United States but not as physicians.

On burnout measures, physicians were more likely to have signs of emotional exhaustion compared with population control participants (32.1% vs 23.5%), depersonalization (19.4% vs 15%), and overall burnout (37.9% vs 27.8%; P < .001 for all comparisons).

Comparison of Employed MDs and Employed US Population

	Physicians(n = 6179)	Population Control Participants (n = 3442)
Emotional exhaustion: high score	32.1%	23.5% (P < .001)
Depersonalization: high score	19.4%	15% (P < .001)
Burned out	37.9%	27.8% (P < .001)
Satisfaction with work-life balance ("work schedule does not leave enough time for my personal or family life")	40.1%	23.1% (P < .001)

Burnout by Specialty

"Substantial" differences in burnout were also observed among different specialties.

Burnout rates were highest among physicians on the front line of care access, including family medicine, general internal medicine, and emergency medicine. It was lowest among pathologists, dermatologists, general pediatricians, and those practicing preventive medicine.

Differences between specialties were also documented with regard to satisfaction with work-life balance. Again, those practicing dermatology, general pediatrics, and preventive medicine had the highest rates for satisfaction with work-life balance, whereas those practicing general surgery, general surgery subspecialties, and obstetrics/gynecology had the lowest rates.

Dissatisfaction with work-life balance was also slightly higher among female physicians than among their male counterparts, whereas it was similar for men and women among control participants in the US population. Unlike fields outside of medicine, in which higher levels of education and professional degrees seem to reduce the risk for burnout, having a degree in medicine increased the risk, the investigators add.

On multivariate analysis, the number of hours worked per week was associated with a higher probability of burnout, whereas being older and being married were both significantly associated with a lower overall risk.

"Burnout can have serious personal repercussions for physicians," investigators observe. "When considered with the mounting evidence that physician burnout adversely affects quality of care, these findings suggest a highly prevalent and systemic problem threatening the foundation of the US medical care system."

Funding for the study was provided by the American Medical Association and by the Mayo Clinic Department of Medicine Program on Physician Well-Being. The authors have disclosed no relevant financial relationships.

Arch Intern Med. Published online August 20, 2012. Full article