Feeling powerless, unimportant and useless? Angry and hopeless? Crippled with cynicism and detachment? Full of pessimism and isolation? These are all signs of physician burnout. Add to this list: chronic fatigue; insomnia; impaired concentration; irritability; poor performance; anxiety; depression; and viewing people as objects rather than as human beings; and you have a picture of medical professionals who are tripping along a precipice. Burnout is very real and a growing issue with physicians, and it is just now rising to the level of what we could call “moderately well-publicized concern.”
Burnout begins in medical school; medical students have 15-30% higher rates of depression than the general population. Three hundred to 400 physicians commit suicide each year. This is not a situation to be swept under the rug.
An Archives of Internal Medicine study found that 1 in 2 physicians report at least one symptom of burnout. Think about the implications of that. Whenever you and another colleague are together, chances are that one of you feels burned out. If four of you are having coffee together, two of you are burned out. What does that say for the state of quality in healthcare today? What does it say about the ability of you and your colleagues to achieve the patient care goals that drew you to medicine in the first place?
Statistics may be the window through which we can assess the situation, but the human toll of burnout is deeply troubling. Physicians deserve support. Yet the very thing causing burnout – stress – seems inextricably woven into the fabric of the medical profession. According to the JAMA study,
Physicians are twice as dissatisfied with their work-life balance when compared to those in other professions.
A landmark study of 7,000 doctors conducted by the Mayo Clinic, and reported by U.S. News & World Report, demonstrates a clear picture of the prevalence of burnout:
- Nearly half of US physicians – 49% – meet the definition for overall burnout, compared with 28% of other US workers
- More than 54% of doctors have at least one symptom of burnout
- Doctors experience emotional exhaustion and depersonalization at a rate 1.5x more than the general working public
- Doctor’s satisfaction with work-life balance is far lower than that of others: 36% versus 61%
- More than 7% of employed physicians between ages 29 – 65 reported that they’d considered suicide within the last 12 months, compared with 4% of other workers,
Some in the medical profession have been kicking and screaming, figuratively speaking, to call attention to this situation and obtain support and treatment for young physicians.
In a letter to the editor of JAMA psychiatry published in the summer of 2015, three doctors implored the Accreditation Council for Graduate Medical Education to recognize the gravity of physician depression. They implored medical schools to educate medical school students on “the risk factors and warnings signs of burnout and depression and equip them with resilience promoting strategies that will empower them to successfully adapt to adversity.”
Are your suffering from burnout?
Burnout is a like a slow, creeping fog. You notice it is there, but you don’t pay much attention to it. Eventually, you realize it hasn’t gone away, but you still believe it will. Then one day you look up and the fog is so pervasive, you can’t see through it.
That’s because burnout is insidious. Your mind and body will give you warnings, but they are easy to ignore. You can tell yourself the chronic fatigue will go away and that someday you will like your work again. But only when you acknowledge the real and present danger that burnout poses to your mental, emotional and physical health will you take action.
Psychology Today says the signs and symptoms of burnout “exist along a continuum. In other words, the difference between stress and burnout is a matter of degree, which means that the earlier you recognize the signs, the better able you will be to avoid burnout by addressing the symptoms.”