American Academy of Pediatrics President Kyle Yasuda, M.D. addresses a growing crisis in American medicine:
U.S. physicians have the highest suicide rate of any profession — higher than the military and more than double that of the general population.
With more than one medical student or physician committing suicide each day, physician resiliency is not just a concern; it’s an emergency.
Nearly two years ago on The PediaBlog, we cited physician burnout as one of the major contributors to this grim statistic:
“[F]atigue, emotional exhaustion and crippling self doubt” [are] reasons why about 400 doctors — the size of entire medical schools — commit suicide in the U.S. annually.
Last year, more than 15,000 doctors across 29 specialties completed an online survey about their degree of burnout and depression. Marcia Frellick reports that urologists (54%) and neurologists (53%) have higher-than-average feelings of burnout:
Responses to a new Medscape survey indicate that 44% of physicians meet the criteria for burnout, up from 42% in last year’s report.
In addition, 11% are colloquially depressed (feeling down or sad), and 4% are clinically depressed, according to the Medscape National Physician Burnout, Depression & Suicide Report 2019.
The responses show that 14% have had thoughts of suicide but have not attempted it, and 6% said they preferred not to answer. Survey authors note that one physician a day dies by suicide, the highest rate of any profession. According to this survey, 1% of physicians have attempted it.
More women doctors report burnout than men, says Frellick:
Women had much higher burnout rates in the survey (50% vs 39% for their male counterparts). Several things may explain that, said Carol Bernstein, MD, a psychiatrist at New York University’s Langone Medical Center. Among them are that women typically are more likely to admit the problem and that women bear disproportionately more child care and household responsibilities.
One female family physician experiencing burnout who responded to the survey said, “I’m having medical problems as a result, having recurrent miscarriages.”
Others gave examples of other side effects. An anesthesiologist said that as a result of burnout, “I’m drinking more and have become less active.”
“My relationships have withered…my family is frustrated,” a general surgeon wrote. “We rarely make plans to do anything socially as they are likely to be canceled.”
Why are so many physicians feeling burned out? Just find and ask one:
When asked what leads to burnout in their lives, 59% of physicians said too many administrative tasks. The next most common answer was spending too much time at work (34%) and increased computerization of practice, such as the use of electronic health records (EHRs) (32%).
Physiatrists (physical medicine and rehabilitation), emergency room physicians, and internists were the most miserable respondents in the survey. Who’s happiest? Plastic surgeons, public health and preventive medicine specialists, and ophthalmologists are. While pediatricians rank higher on the “happy” scale compared to other specialties, Dr. Yasuda says burnout remains a concern:
Pediatricians become burned out not because we’re weak but perhaps because we care too much. Burnout occurs when we know what to do for our patients, but we’re unable to do it because too many suffer from social inequities and a lack of resources. Add to that the administrative and regulatory burdens (billing, inadequate payments, documentation), and we start to feel less like healers and more like data entry clerks, spending more time on tedious things and less on what matters most.
Pediatric residents have high rates of burnout, too, according to a 2017 survey of young pediatricians-in-training. A study published last year found that answers to two screening questions — “I feel burned out from my work” and “I have become more callous to other people since I took this job” — are especially helpful in identifying pediatric residents who may be in need of some counseling for their feelings of burnout. Perhaps these are two questions every doctor must ask themselves and seek help if they answer in the affirmative.