“Understanding what your audience is feeling is important, particularly with physicians who are feeling that they are already spending too many hours at work and are frustrated with too many bureaucratic tasks,” says Dr. Michael Smith, chief medical editor for WebMD. “Reps should take this into account before they make their visit, look for ways to make it more efficient and offer value.”
Dr. Smith says that because the data indicates that front-line physicians are experiencing greater distress than other working Americans, it is critical to target what is causing burnout. “The Medscape 2013 Lifestyles Report showed an excessive workload and loss of control over the profession were the top causes,” he told Med Ad News. “This includes having too many bureaucratic tasks and spending too many hours at work. These responses were consistent across specialties. Interestingly, the impact of the Affordable Care Act (ACA) was only seen as a stressor by a few specialties including those who performed procedures and whose incomes are threatened by ACA reforms.”
A national survey published in the Archives of Internal Medicine in 2012 reported that U.S. physicians suffer more burnout than other American workers. Some 45.8 percent of physicians were experiencing at least one symptom of burnout: loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment.
In Medscape’s current survey, when members were given the same criteria, the response was nearly as discouraging: 39.8 percent responded that they were burned out and 60.2 percent said that they were not. The two specialties with the highest percentage of burnout were those that dealt with severely ill patients: emergency medicine and critical care. Among the top 10 were most of the generalists: family physicians, obstetricians/gynecologists, internists, and general surgeons. Surprisingly, pediatricians were among the least burned-out specialists, along with rheumatologists, psychiatrists, and pathologists.
“The two specialties with the highest percentage of burnout were those that dealt with severely ill patients—emergency medicine and critical care,” Dr. Smith says. “However, within the top seven were family medicine, obstetrics and gynecology, internal medicine, general surgery, and anesthesiology.
These physicians are the first line of contact with patients and must be readily available. The brunt of paperwork, regulation, and health insurance hoops falls to them and their staffs. The combination of these factors helps explain why burnout is more common among these specialties.”
More female physicians reported burnout (45 percent) than male physicians (37 percent), which may be attributed to the fact that women tend to enter generalist professions such as family medicine, internal medicine, and obstetrics/gynecology, rather than the lower-stress subspecialties.
“According to a 2000 Physician Work Life Study, female physicians said that they face a more difficult patient mix, and more time pressure in patient examinations,” Dr. Smith told Med Ad News. “In effect, the extra stress arises from the greater time and effort being expected of them to communicate with patients and address psychosocial and health maintenance issues, rather than the issues related to family-work conflicts. This underlying difference in gender-related work expectations might explain why approximately 45 percent of female physicians are burned out compared to 37 percent of their male counterparts.”
The rate of burnout is lowest in the youngest and oldest physicians, according to the Medscape survey. It peaks in midlife (46-55 years) at 32 percent and then declines thereafter. This could suggest that older physicians have developed better ways to cope with professional life, that the older generation had a better environment to work in than the current one, or that they are cutting back on hours. According to Dr. Smith, this suggests that older physicians have developed better ways to cope with professional life, that the older generation had a better environment to work in than the current one, or that they are cutting back on hours. “Additionally, the younger generation might not be feeling the same pressure since they have not been practicing as long or they have ‘grown up’ in an age of practicing medicine where such pressure are seen as the norm,” he told Med Ad News.
Different approaches may be necessary to prevent burnout, Dr. Smith says. “Burnout among physicians appears to have a different basis from burnout in other professions, so the remedies may need to be different. Most of the literature focuses on individual interventions centered on stress reduction training rather than organizational interventions designed to address the system factors that result in high burnout rates. When combined with positive changes in the healthcare environment, our findings emphasize the need to help physicians learn how to reach out to friends, family members, and work colleagues to help when symptoms of burnout emerge. Medical and physician support programs are already in place in every state throughout the country and have reported many successes in helping
physicians with burnout and other kinds of stress-related problems.”
Not surprisingly, burnout has a negative impact on morale. “The evidence certainly suggests that burnout is a big problem among physicians,” Dr. Smith told Med Ad News. “In a major survey of U.S. physicians by the Physicians Foundation, in response to how they would rate the professional morale of other physicians they knew, 80 percent said that it would be either somewhat or very negative, and when asked about their own morale, 72 percent responded in the negative. The percentages are striking and might suggest deep discouragement with the present healthcare environment. It should be noted, however, that although almost 58 percent said that they would not recommend a career in medicine to young people, 66 percent still would choose medicine if they were starting all over again.”
Income not being high enough was among one the causes of burnout. “The interesting results from the 2013 Medscape Lifestyle survey suggest that for those with burnout income seems to be a major factor, although whether this is a consequence or a cause is not known,” according to Dr. Smith. “When responding to the Medscape survey question about savings, 39 percent of burned-out physicians consider themselves to have minimal savings or unmanageable debt compared with 24 percent of their less stressed peers. Meanwhile, 69 percent of the non-burned-out physicians said that they have at least adequate savings, if not more, compared with 59 percent of their burned-out peers. Although incomes tend to be lower among primary care physicians than subspecialists and surgeons, burnout across all specialties was associated with a perception of lower savings and more debt. It would appear
that it may not be the absolute number of dollars that contributes to feelings of burnout, but the lower amounts of savings and higher debt load compared to their peers.”
REFERENCE: By Mia Burns; PharmaLive