Physician burnout
Burnout is an alarmingly common problem among physicians that affects approximately half of psychiatrists. In 2014, 54.4% of physicians, and slightly less than 50% of psychiatrists, had at least 1 symptom of burnout.4 This was up from the 45.5% of physicians and a little more than 40% of psychiatrists who reported burnout in 2011,4 which suggests that as medicine continues to change, doctors may increasingly feel the brunt of this change. The rate of burnout is highest in front-line specialties (family medicine, general internal medicine, and emergency medicine) and lowest in preventive medicine.5 Physician burnout leads to real-world occupational issues, such as medical errors, poor relationships with coworkers and patients, decreased patient satisfaction, and medical malpractice suits.6,7
Even though burnout is clearly a concern for our colleagues, don’t expect them to proactively line up outside our offices. In a survey of 7,197 surgeons, 86.6% of respondents answered it was not important that “I have regular meetings with a psychologist/psychiatrist to discuss stress.”8 At the same time, the idea of meeting with a psychologist/psychiatrist was rated more highly by surgeons who were burnt out and found to be a factor independently associated with burnout.8 Perhaps we have some work to do in marketing our services in a way that welcomes our colleagues.
Although physician burnout has been a focus of recent studies, burnout in general has been studied for decades in other working populations. There are 2 useful models describing burnout:
- The job demand-control(-support) model suggests that individuals experience strain and subsequent ill effects when the demands of their job exceed the control they have,9 and social support from supervisors and colleagues can buffer the harmful effects of job strain.10
- The effort-reward imbalance model suggests that high-effort, low-reward occupational conditions are particularly stressful.11
Both models are simple, intuitive, and suggest solutions.
When engaging your physician colleagues about their burnout, remember that physicians are people, too, and have the same difficulties that everyone else does in successfully practicing healthy behaviors. As physicians, we have significant demands on our time that make it difficult to control our ability to eat, sleep, and exercise. In general, the food available where we work is not nutritious,12 half of us are overweight or obese,13 and working more than 40 hours per week increases the likelihood we’ll have a higher body mass index.14 We don’t sleep well, either—we get less sleep than the general population,15 and more sleep equates to less burnout.16 Regarding exercise, doctors who cannot prioritize exercise tend to have more burnout.17
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