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Primary Care Physicians Burning Up, Burning Out-But Not Bailing Out


Despite the considerable toll clinical practice is taking on primary care physicians, most don't seem to be hanging up their stethoscopes . . . at least not yet.

If you want more numbers to confirm that many of your physician peers are experiencing symptoms of professional burnout, you can find new data in a recently posted Medscape survey.

That survey shows that roughly 1 of 4 doctors across various specialties are dealing with at least 1 symptom of burnout-a loss of enthusiasm for work, a sense of cynicism, and/or feelings of inadequate personal accomplishment. Rates of burnout and its level of severity vary across clinical specialties.

Emergency and critical care physicians topped the burnout charts. The Table also shows the toll that primary care is taking on family physicians, ob/gyns, and internists, who reported burnout rates as high as 45%. The severity of burnout symptoms was also highest in these groups.

Most severely stressed? Ob/gyns . . . this group averaged 4.3 on a scale of 1 to 7, with 7 being the most severe. Family physicians and general internists aren’t far behind, with an average score of about 3.8.

Pediatricians were the surprising exception: rates of burnout and symptom severity in this group were among the lowest across the specialties.

A score of 7 on the burnout severity scale was defined as symptoms so severe that the physician was thinking of leaving medicine altogether. To the extent that this survey accurately reflects current trends then, physicians don’t seem to be hanging up their stethoscopes despite the burdens of clinical practice . . . at least not yet.

The top causes of burnout? In descending order, here’s how survey respondents rated various factors:
• Too much bureaucracy
• Too many working hours
• The present and future impact of the Affordable Care Act
• Income not high enough
• Inability to provide quality patient care
• Increasing computerization of practice
• Compassion fatigue

Other survey highlights:
• More female than male physicians report burnout (45% vs 37%, respectively).
• Those in their midlife years (46-55) report higher rates of burnout.
• Burnout appears to take a toll on physicians’ health.
• Nearly a third of burned out doctors believe they have minimal savings for their age and professional stage versus 21% of their non–burned out peers.

One more survey tidbit:

• When it comes to vacations, Americans lag far behind. We get an average of 13 paid vacation days a year. This compares with 42 days for Italians, 37 for Germans, 28 for Britons, 26 for Canadians, and 25 for Japanese. Nearly 40% of burned-out physicians take 2 weeks or less of vacation.

The Medscape survey comes on the heels of a 2012 national survey of burnout and satisfaction with work-life balance among American doctors. In their survey of 27,267 physicians, Shanafelt and colleagues1 found that 45.8% were experiencing least 1 symptom of burnout. As with the Medscape survey, rates varied by specialty: those on the front lines of care were most stressed. Burnout rates among non-physicians were lower.

How to reduce stress and avoid burnout? Perhaps the strategies and tips offered in these articles may prove helpful.

9 Ways to Avoid BurnoutHeading Off Physician BurnoutPhysician Heal Thyself First Reference
1. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med.2012;172:1377-1385.

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