Burnout has been a growing problem for physicians for years now, driven in part by factors such as temperamental electronic health records and a shortage of skilled professionals relative to the number of patients. But finally, some good news: The epidemic levels of physicians reporting burnout dropped modestly in 2017, according to new research.
The study by researchers at the Stanford University School of Medicine, the Mayo Clinic and the American Medical Association found that while physicians are still at higher risk for burnout than are other professionals, there's been an improvement in symptoms nationally.
Burnout decreased and satisfaction with work-life integration improved between 2014 and 2017, according to the study. Still, levels of burnout remain markedly higher than in other fields. About 44 percent of physicians reported at least one symptom of burnout, and only about 43 percent reported satisfaction with their work-life integration, which was less than in 2011.
Dr. Tait Shanafelt, director of Stanford's WellMD Center and the study's lead author, first conducted studies on physician well-being almost two decades ago.
Over the years, research uncovered evidence of growing distress and cynicism among physicians due, in part, to spending more time on clerical work at the expense of time spent with patients. Increasing workloads and regulations contributed to high levels of emotional exhaustion and job dissatisfaction.
Physicians were leaving their jobs, and their suicide levels were markedly higher than those of other professionals.
To conduct the current study, researchers sent surveys to a nationwide sampling of physicians and workers in other fields. Among physicians, 5,445, or about 17 percent, completed the survey. Of these, 43.9 percent reported at least one symptom of burnout in 2017, compared with 54.4 percent in 2014 and 45.8 percent in 2011. Symptoms of burnout among workers in other fields remained the same -- about 28 percent.
The improvement from 2014 to 2017 in symptoms indicating burnout weren't seen among physicians in all specialties. Levels among certain specialties, including general surgery and obstetrics and gynecology, failed to show any significant reduction in 2017.
Also, the proportion of physicians screening positive for depression showed a modest but steady increase in three studies conducted over the years by the team: 38.2 percent in 2011, 39.8 percent in 2014 and 41.7 percent in 2017.
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The researchers could only speculate about what may have contributed to the decrease in burnout levels in 2017. One possibility is that a large number of burned-out physicians left the workforce, so they were no longer included in the study.
Another possibility is that 2014 may have been a particularly challenging time for physicians due to consolidation of hospitals and medical groups, a number of new regulatory factors, and increased administrative burdens.
But the authors are hopeful that growing national efforts by government agencies, professional organizations and medical institutions to improve working conditions for physicians may be making a difference.
The burnout problem may improve further when true EHR interoperability arrives. While electronic health records improve communication and access to patient data, researchers found in December that stress from using EHRs is associated with burnout, particularly for primary care doctors such as pediatricians, family medicine physicians and general internists.
Common causes of EHR-related stress include too little time for documentation, time spent at home managing records and EHR user interfaces that are not intuitive to the physicians who use them.