As the COVID-19 pandemic nears the one-year mark in the U.S., it's becoming evident that its detrimental effects go beyond just physical health. It's also taking a toll on the mental and emotional wellbeing of physicians, with female physicians and those in critical care and infectious disease reporting the highest rates during the public health emergency, according to findings from a new physician burnout report from Medscape.
Although burnout rates were stable from the previous year's report, at 42% overall, the level in women increased from 48% to 51% during the pandemic, while burnout in male physicians overall remained unchanged from 2019.
WHAT'S THE IMPACT?
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Hospitals have been overwhelmed and short-staffed as the coronavirus has reached new peaks in many areas of the country, straining resources and stretching the workforce thin.
More than 12,000 physicians across 29 specialties responded to the survey, conducted between August 30 and November 5, 2020. Burnout is described as long-term, unresolved job-related stress leading to exhaustion, cynicism, detachment from job responsibilities and lacking a sense of personal accomplishment.
Burnout and the stress of the pandemic – including factors such as personal risk, social distancing and financial uncertainty – appeared to diminish physicians' overall work life happiness, with only 49% reporting they were happy in 2020 versus 69% pre-pandemic. More than one-third (34%) reported feeling unhappy last year, compared with 19% in 2019.
Nearly 80% of physicians said they felt burned out prior to the pandemic, but one in five said their burnout emerged only last year. Critical care (51%), rheumatology (50%) and infectious disease specialists (49%) ranked among the highest in reporting burnout for the first time since Medscape began surveying on the issue in 2013.
PATIENT CARE, OTHER CAUSES
Nearly three quarters of millennial physicians (25-39) and Gen Xers (40-54) and two-thirds of baby boomers (55-73) said burnout has had a negative effect on their personal relationships.
As in previous years, of the 20% of physicians who said they were depressed, one in five physicians reported clinical depression, and more than two-thirds (69%) said they felt "down" during 2020. Of those reporting depression, 13% said they experienced suicidal thoughts, and 1% attempted suicide.
More than one-third of all physicians who report depression say it leads them to be more easily exasperated with patients, 24% are less careful when taking patient notes and 15% said depression results in them making errors they would otherwise not make.
Although COVID-19 exacerbated existing issues that have contributed to physician burnout over time, the stress of treating coronavirus patients did not substantially increase burnout.
Instead, nearly two-thirds of doctors cited their long-standing problem with excessive bureaucratic demands, and more than one-third pointed to long hours (37%). Only 8% of doctors said the stress of treating COVID-19 patients was the primary cause of their burnout. Both male and female physicians cited work-life balance as their main concern, with 42% of physicians indicating that a more manageable schedule would help reduce burnout.
THE LARGER TREND
Research by faculty at George Mason University's College of Health and Human Services found that healthcare professionals with a greater personal ability to respond to change experienced lower rates of burnout when their work environments offered strong communication, teamwork and leadership support.
Work environments and job demands have a significant effect on the health and wellbeing of frontline care workers, which may also affect the health of patients, findings showed. With the COVID-19 pandemic ratcheting things up several notches, it's more important than ever to be aware of the effects these hardships can have.
Among all types of healthcare professionals (providers, clinical support staff and administrative staff), both practice and individual factors were related to levels of burnout. Lower levels of burnout were reported among those who had higher scores for individual response to change and among practices that had higher organizational capacity for change.
ON THE RECORD
"The incidence of burnout and depression among physicians has been a concern for years, and the pandemic only made a bad situation worse," said Leslie Kane, senior director, Medscape Business of Medicine. "This is especially true in frontline specialties and in female physicians, whom we know have borne the brunt of at-home schooling and other disruptions. Post-pandemic, healthcare organizations and the medical community have an opportunity to re-think how best to support physicians so that we start to see meaningful reductions in burnout, depression and suicide rates moving forward."
Championing the caregiver experience
This special collection, which will be updated throughout the month, looks at what's being done to ease the burden on providers impacted by COVID-19.