Physicians Anonymous

The global physician burnout pandemic

The global physician burnout pandemic

Long before the COVID pandemic, doctors across the world were suffering from ‘a pandemic of physician burnout’, according to former World Medical Association President, Dr Leonid Eidelman. This global physician burnout pandemic needs to be addressed. Stat! 

In this article, we explore burnout statistics and causes from around the world.

Why is physician burnout important?

Increasingly, physician burnout has been recognised as a public health crisis in many countries because it not only affects physicians’ personal lives and work satisfaction but also creates severe pressure on the whole health-care system—particularly threatening patients’ care and safety.

Physician burnout is linked to:

  • Worse patient outcomes
  • Lower patient satisfaction
  • More medical errors
  • Higher staff turnover
  • Higher healthcare costs
  • Poor physician mental and physical health
  • Possibly physician suicide.

Moreover, Dr Eidelman rightly asserts that ‘Physician burnout is a symptom of a larger problem – a healthcare system that increasingly overworks doctors and undervalues their health needs’.

Global physician burnout statistics

The former WMA President stated that nearly half of the world’s 10 million physicians had symptoms of burnout. These symptoms include emotional exhaustion, interpersonal disengagement, and a low sense of personal accomplishment.

Below, we gather the findings into doctor burnout from several countries, and then focus on a pre-pandemic 6-country report into physician burnout.

Physician burnout is a symptom of a larger problem – a healthcare system that increasingly overworks doctors and undervalues their health needs.

  • The most recent US Medscape’s National Burnout and Depression Report 2022 reported a further rise in burnout prevalence from 42% in 2021 to 47% in 2022
  • A survey of 4,000 physicians and medical learners, also known as residents, done by the Canadian Medical Association in November 2021 showed 53% have experienced “high levels” of burnout, compared to only 30% four years before.
  • Some 80% of doctors in a British Medical Association 2019 survey were at high or very high risk of burnout, with junior doctors most at risk, followed by general practitioner partners
  • DXY (the largest Chinese physicians’ online community) reported that more than two-thirds of Chinese physicians were suffering from burnout in 2018 (quoted in The Lancet)
  • A meta-analysis of >22,000 residents (registrars/trainee doctors) from 10 countries reported an aggregate burnout prevalence of 51%.

Medscape's 2019 Global Physicians' Report

Medscape’s 2019 Global Physicians’ Burnout and Lifestyle Comparisons Report included responses from nearly 20,000 doctors in six countries (France, Germany, Portugal, Spain, the United States, and the United Kingdom).

While this report was pre-pandemic, it gives us a good starting point.

Key results:

  • More than one in three doctors worldwide (37%) feels burned out (range 36-51%)
  • One in ten (10%) experiences both burnout and depression
  • Physicians from Portugal and Spain reported considerably higher levels of burnout than their counterparts in other countries, (47% and 43% respectively)
  • Physicians in the UK, the US and France reported levels of 32%, 40% and 42% respectively.
  • German doctors were the least burned out, at 21%. Regarding depression, however, nearly one in four German physicians reported being depressed, followed by French physicians, with only 6% reporting depression.

Impact of burnout

The French and UK doctor communities appeared to feel the effects of burnout most acutely, with a quarter (23-25%, respectively) saying the impact was so severe they were thinking of abandoning medicine altogether. The US, Germany and Portugal fared slightly better, yet one in five doctors in these countries were considering leaving medicine.

Spanish doctors indicated the lowest impact, with one in four (27%) saying that burnout did not interfere with their lives and only 9% saying they were considering leaving the profession.

Causes of burnout and depression

Most physicians reported that unhappiness with work was the key factor for their burnout and depression. Common themes driving burnout were:

  • Excessive bureaucratic tasks (response rates ranged from 47% in the UK and Spain to 56% in the US and Portugal)
  • Spending too many hours at work (rates ranged from 26% in Spain to 51% in Portugal)
  • A lack of respect from administrators and employers (rates ranged from 25% in the US to 40% in Portugal).
  • Frustrations with local healthcare systems also emerged: UK doctors reported government regulations and a lack of autonomy (25%, respectively) as key influences in burnout, and Spanish doctors thought insufficient compensation was an important factor (56%). 

Getting help (or not)

The majority of doctors said they had not sought professional help for burnout and/or depression (58%), with reasons given:

  • symptoms not being severe enough (46%)
  • being too busy to address them (33%)
  • thinking they could manage the situation without professional help (38%).

So nearly 60% of burned out/depressed colleagues think that they can manage the situation themselves. (Disclosure: I was one of those!)

Reality check: if they had the tools to do so, they would not be burned out or depressed.

[This links to the Dr Superman Fallacy, soon to be featured in another blog.]

What would help reduce global physician burnout?

 

The differences above are likely to reflect the predominant local health system challenges. The US scored highest in the need for reduced work hours, greater respect from administrators etc, and more reasonable patient loads.

While the US scored highest, each country surveyed has physicians asking for more manageable workloads, greater respect, greater patient focus rather than profits, and better financial compensation to avoid financial stress.

Similarly, doctors across all  6 countries wanted more schedule flexibility, greater respect from patients, and increased control. Nearly twice as many doctors in the UK and US felt increased autonomy would reduce their burnout, compared to the sampled European countries. Portugal and Spain were outliers in their doctors’ desire for more educational and professional growth opportunities to alleviate burnout.

Conclusions

Physician burnout is a global problem, indeed it was a pandemic before the COVID pandemic.

Burnout is caused by unmanageable stress, which is a systemic problem, because physicians do not lack resilience.

Solving the complex, entrenched, and multiplex systemic contributors to physician burnout will take a concerted interdisciplinary approach. And it will take time. 

In the meanwhile, doctors are suffering, and in some cases, dying.

One evidence-based solution is for doctors to be able to access safe, confidential, and anonymous peer-support and group coaching online from anywhere in the world.

That is our vision at Physicians Anonymous.

If you would like to help us, please Contact Us with your ideas. If you would like to find out more, please Join Us

Thank you!

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