Burnout in Physicians _ _______________________________________________________________________
PREVALENCE OF BURNOUT Since the early 2000s, many studies and surveys have been done to assess burnout in physicians, and the rates have ranged from 27% to 63%, with rates of 50% to 78% among medical students and residents [28; 32; 33; 34; 35; 36; 37; 38; 39; 40; 41; 42; 43; 44; 45; 46; 123; 124]. These rates are somewhat consistent with the findings of more recent surveys of physi- cians in all specialties. One of these surveys, a 2014 study of nearly 7,000 physicians, showed an overall rate of burnout of 54% [30]. Another survey, reported on in the 2015 Medscape Lifestyle Report, represents the findings from nearly 20,000 physicians; the overall burnout rate was 46% [31]. Because burnout can be assessed and reported differently in each survey, it can be useful to look at the change over time in each. The rates in both surveys are higher than those previously reported by both authors: from 46% in 2011 to 54% in the 2014 study, and from 40% in 2013 to 46% in the 2015 report [30; 31]. These rates reflect a much higher rate of burnout among physicians compared with the general U.S. population, which was reported to be 28% in 2014 [30]. The 2021 Physicians Foundation and AMA/Mayo Clinic surveys reported burnout rates of 61% and 62.8%, respectively [123; 124]. The Mayo Clinic, which has been studying burnout rates for more than a decade, found that 2014 seemed to be a peak [125]. Burnout rates across nearly all specialties increased greatly that year compared to 2011, but in their 2017 survey, rates dropped precipitously and continued that trend in 2020. Six to nine months into the COVID-19 pandemic, the 2020 Mayo Clinic survey did not indicate that physician burnout had again increased. However, 12 to 15 months later, burnout in nearly all specialties increased precipitously. As Maslach noted, the prevalence of burnout among physicians varies according to several factors, including age, sex, marital status, and career stage [6]. In addition, among physicians, the prevalence varies according to specialty area. Burnout According to Age and Sex Age is a factor in burnout among physicians, with the lowest rate (35%) among physicians 34 years of age and younger [47]. The highest rates of burnout are found for physicians who are middle-age: 50% for physicians 45 to 54 years of age and 44% for physicians 35 to 44 years of age [128]. Specialty has an effect on the prevalence according to age. For example, in the Medscape survey, the overall burnout rate was 35% for physicians 34 years or younger, but rates were much higher among physicians in small specialties such as urology (54%), neurology (53%), and physical medicine and rehabilita- tion (52%) [31; 128]. In a survey of family physicians and general internists, female physicians were nearly twice as likely as male physicians to report burnout (36% vs. 19%) [29]. Other studies have found differences in burnout according to sex, but not at the same magnitude. For example, Dyrbye et al. found burnout rates of 43% for female surgeons and 39% for male surgeons, and in the Medscape survey, the rates were 51% and 43% for female
and male physicians, respectively [31; 48]. The 2021 Physi- cians Foundation survey found that 69% of female physicians reported “often experience feeling of burnout,” compared with 57% of male physicians [123]. As with physicians overall, the burnout rates among women have varied substantially accord- ing to specialty, with the highest rates for female physicians found in urology (67%), orthopedics (61%), critical care (61%), cardiology (60%), general surgery (59%), and emergency medi- cine (58%) [31]. Among residents, women are more likely than men to have burnout according to scores on the emotional exhaustion and personal achievement subscales [29]. Burnout According to Career Stage In keeping with Maslach’s theory that burnout usually occurs within the first five years of an individual’s career, burnout rates are higher among medical students and residents than among physicians. In one study, the odds of burnout were higher for residents and fellows than for medical students and early-career physicians, and all three of these groups were significantly more likely to be burned out than college graduates of similar ages in other careers [49]. Similarly, a systematic review showed that residents in surgical specialties were more likely to be burned out than attending surgeons [50]. At the other end of the spectrum, the burnout rate is low among internal medicine residency program directors, with a rate of overall burnout of approximately 29% in one study [38]. In a comparison of burnout among physicians in early, middle, or late career (10 years or less, 11 to 20 years, and 21 years or more, respectively), the rate for depersonalization was highest among middle-career physicians [51]. The high rates of burnout among physicians in training are of concern because when burnout develops early during training, it tends to persist throughout residency [35]. Burnout According to Specialty Area Over the years, the rate of burnout among physicians has varied across specialties, with the highest rates reported among so- called high-stress specialties, such as critical care, emergency medicine, and oncology, as well as among physicians on the frontline of care, such as family practice and internal medicine [11]. The rates found in the 2019 Medscape report are some- what consistent with this trend, with critical care, neurology, family medicine, obstetrics/gynecology, and internal medicine being the specialties with the highest rates of burnout [47]. The 2021 AMA/Mayo Clinic survey noted that burnout greatly increased among physicians practicing in emergency medicine, critical care medicine, hospital medicine, and infectious disease during the COVID-19 pandemic, and the 2024 Medscape report continues to bear this out ( Table 4 ) [124; 129]. The rate of burnout in emergency medicine increased from a reported 48% to 63%, while subspecialities of internal medicine such as pulmonology and oncology increased from 39% to 50% and 39% to 53%, respectively. Obstetrics/gynecology rose from 45% to 53% between 2019 and 2025. While some special- ties, such as urology, neurology, and physical medicine and rehabilitation, have shown slightly lower rates of burnout, the general trend across specialties shows an increase both during and after the COVID-19 pandemic [129].
59
MDPA2126
Powered by FlippingBook