Doctors report high burnout, and low impact of wellness efforts

Even beyond the worst of the COVID-19 pandemic, too many doctors are struggling with burnout and feelings of hopelessness.

More than half of all doctors (60%) say they often experience feelings of burnout, according to a new report from The Physicians Foundation. The foundation produces an annual report on the wellness of doctors, and this is the fourth consecutive year that six in 10 doctors reported regular feelings of burnout. Six in 10 residents also reported experiencing burnout.

Gary Price, president of The Physicians Foundation, tells Chief Healthcare Executive® that he’s disturbed to see such persistently high levels of burnout among America’s doctors.

“The overall arching conclusion of our study, and I think one of the most important things, is that we're continuing to see just dramatically high levels of burnout symptoms in our healthcare workforce, despite the fact that we're now two years out of the COVID-19 pandemic,” Price said in a statement.

In 2018, 40% of doctors were experiencing burnout, according to the foundation’s survey, and Price said that was a troubling percentage back then. “Those levels were really a great concern before the pandemic,” he says.

Many doctors are struggling with the heavy administrative burdens they encounter in documenting patient encounters or wrestling with insurers to get approval for their patients.

Physicians say they are also discouraged by a lack of autonomy in making the best decisions for patients and being pressed to see more patients, giving them less time for each visit. Price says those concerns are amplified by the growing consolidation of the healthcare industry.

• Read more: Doctors cite downsides in hospital, health system mergers

Too many doctors are reluctant to get treatment for their mental health, Price says. And many doctors aren’t seeing the benefits of efforts to improve the workplace, which healthcare executives need to recognize, he adds. (See part of our conversation with Dr. Price. The story continues below.)

Stigma persists

Some doctors are saying they are leery of getting assistance for their mental health, because they are worried it could hurt their careers.

“Physicians are telling us that part of that is still an ongoing perception of a stigma that surrounds seeking help with behavioral health issues,” Price says.

At least three-quarters of doctors (77%), residents (75%) and medical students (78%) say they perceive a stigma in getting treatment for their mental health, the foundation survey found.

A sizable number of doctors (40%) and residents (44%) said they or someone they knew was worried about seeking treatment due to questions on medical license or credential applications.

“One of the big reasons they list for not seeking help is their perception of state licensing questioning and attitudes towards seeking any type of psychological care,” Price says.

Those concerns are especially disappointing to Price, since his organization has been working with the Dr. Lorna Breen Heroes Foundation to improve the mental health of clinicians.

The Lorna Breen foundation has been pushing states to drop invasive questions about mental health on physician licensure applications, and they are having some success. A majority of states have removed questions asking doctors about being treated for mental health. So it’s disappointing to Price that more doctors aren’t aware of those changes.

“We have a problem with the way physicians perceive that, which needs to be addressed,” Price says.

• Read more: Protecting the mental health of young clinicians

A lack of commitment

Doctors also say that they don’t see a commitment from health systems to help clinicians and improve the workplace.

“I think physicians are also telling us loud and clear that they're not perceiving that their healthcare systems are truly committed to making their work environment better and addressing some of these problems,” Price says.

Even with many doctors working in larger hospital systems or physician practices, they don’t see their concerns being addressed, even if those organizations have undertaken efforts to boost wellness.

“I think healthcare executives need to be aware that their physicians really aren't seeing the effects of the efforts they have put in,” Price says.

More healthcare organizations have created executive positions focusing on wellness. Interestingly, some doctors say they aren’t seeing many tangible benefits from those posts.

Doctors say the creation of those positions is at the low end of successful interventions. Less than one-third of doctors (31%) said the addition of a well-being executive has been helpful.

“Perhaps these well-being officers still don't have the right tools to approach the problems in their workplaces, or they don't have the commitment of administrations above them,” Price says.

But he adds that the sentiment is “something I think that healthcare executives have to pay more attention to.”

• Read more: How hospitals can improve the well-being of their workers

Wellness efforts haven’t ‘made a dent’

Overall, physicians are saying they aren’t seeing meaningful changes in their work environment, Price says.

“What we've done so far to deal with these issues hasn't really made a dent in them at all, and we really need to look at what's going on in the way the environment our physicians practice in has changed, and what we can do to make that not just healthier for the people who work in it, but make it a safer place with better outcomes for our patients,” Price says.

Health systems must recognize that they need to focus on their workplace, rather than expending efforts on making doctors more resilient, he says.

Price cited the old mining analogy of canaries in the coal mine.

“Programs to make physicians more resilient was a lot like seeing canaries die in a coal mine and then feeling the solution was to send out for tougher canaries,” Price says.

Doctors are showing that the work environment can be a key factor in driving physicians to seek other positions, according to a separate report from McKinsey & Co. Doctors most often said they were leaving for better compensation (39%), but nearly as many cited a desire for a better work-life balance (38%) and the emotional toll of the job (37%).

Health systems may be more motivated to make changes as they see more doctors leave the workforce, Price suggests.

“I think it will be easier for them to pay more attention to that as physicians get increasingly expensive to replace, and the availability of physicians willing to work in clinical settings diminishes even further,” Price says. “Perhaps, that will give an incentive to improve the situation more within these systems.”

Getting help

988 Suicide & Crisis Lifeline: Dial or text 988 to connect with someone. Help is available 24/7.

The American Foundation for Suicide Prevention offers resources for healthcare professionals.

NAMI: The National Alliance for Mental Illness offers “frontline wellness” resources for healthcare workers and public safety employees.