番茄社区

Six in 10 physicians say they often experience feelings of burnout, a 20% jump from pre-pandemic levels reported in 2018, according to released on Thursday.

A total of 46% of physicians said they have isolated or withdrawn from other people in the last year, more than one in three said they felt hopeless or without a purpose, and 57% reported experiencing "inappropriate episodes of anger, tearfulness, or anxiety."

Perhaps most troubling of all, only 14% of physicians sought medical attention for their mental health concern.

"Over the past year, the pandemic has shone a light on a problem that physicians have always faced: the stigma surrounding accessing mental health support and services for fear of looking weak or believing they will lose their license and credentials," said Gary Price, MD, president of The Physicians Foundation, in a press release.

"Nearly one-fifth of physicians indicated they know of someone who considered, attempted, or died by suicide since the start of the pandemic alone, a time when many physicians have suffered trauma and loss," he added. "It is vital that we make a conscious and forward effort to break down stigma and encourage physicians to seek mental health support when they need it, especially in the wake of the most significant health event in recent history."

When left untreated burnout can lead to depression, anxiety, substance use, post-traumatic stress disorder, and suicidal thoughts, noted the report, which also highlighted that close to 1 million Americans lose their doctor to suicide each year.

The Physician Foundation overhauled its biennial survey to zero in on the pandemic's impact on physicians. Questions asked in its more traditional survey -- such as those related to the electronic health record and value-based payment -- were set aside, but the foundation will continue to explore them in future research.

The 10-minute survey was completed online by 2,504 physicians from May 26 to June 9, 2021; it was emailed to a list of physicians taken from Medscape's proprietary database. Thirty-six percent of respondents were primary care physicians and 64% work in a specialty; 64% of respondents are male, 34% are female, and 2% declined to answer; and 67% of respondents are employed physicians versus 26% independent and 7% reported their practice status as "other." A total of 54% of respondents were between the ages of 36 and 55; 16% were 18-35; and 30% were 56 or older.

"Difficult working conditions such as a lack of personal protective equipment (PPE) and caring for patients who may be seriously ill for weeks -- along with burdensome administrative tasks, long hours, and grief over losing patients -- have become the norm, but little has been done to alleviate the heavy mental health toll on physicians," the report stated.

A majority of respondents cited family, friends, and colleagues as their most helpful sources for mental health support during the pandemic, according to the survey.

Regarding rates of burnout, the report found more women physicians at 69% experienced feelings of burnout than men at 57%.

The fact that both younger and female physicians were more likely to report burnout, could relate to female physicians' "dual roles" as both clinicians and the "primary home makers" or "child caregivers" in the family, the authors of the report said. They explained that research has found that female physicians do an average of 8.5 hours more work at home than their male physician colleagues -- "significantly contributing to burnout risk."

With regard to physicians' financial health and changes in their workplace, 49% of physicians said their income has dropped, 32% saw staff reductions, and 18% transitioned their practice to a primarily telemedicine model.

Drilling down into the problem of falling incomes, the report found that 68% of physicians who noted working independently saw a reduction in income compared with 44% of physicians working for a hospital or health system. Also, a larger share of physicians who are male and 46 or older, saw their income decline.

Only 9% of independent physicians reported moving to a new practice or changing their employment situation.

Most physicians said they anticipate that telemedicine will play a bigger role in their practice, that they expect an increase in more serious health issues due to patients delaying visits because of lockdowns, and a majority predict there will be "significantly fewer" independent practices once the pandemic ends.

A total of 23% of physicians, across a range of demographics, said they want to retire in the next year, a drop from the 38% who reported wanting to retire in 2020.

Returning to mental health issues, the report found that more than half of physicians said they know a physician who has considered, attempted, or died by suicide; one in five said they know a physician who has considered, attempted, or died by suicide since the start of the pandemic.

The rate of suicide among male doctors is roughly and for female physicians that risk is even greater, at 2.27 times higher than the general female population.

Eight percent of physicians reported increased use of medications, alcohol, or illicit drugs on a weekly basis.

More than seven in 10 physicians endorsed a comprehensive approach to addressing mental health conditions including confidential therapy or counseling or support phone lines, peer-to-peer support groups, and evidence-based training to prevent burnout, behavioral health problems, and suicide.

Nearly three-quarters of respondents supported a "change or removal of medical licensure questions that stigmatize accessing behavioral healthcare." (See also 番茄社区's "Do Docs Deserve Mental Health Privacy")

Younger and female physicians placed more importance on the availability of and access to mental health resources than older and male physicians, according to the survey.

Forty-six percent said they would still recommend medicine as a career.

If you or someone you know is considering suicide, call the National Suicide Prevention Hotline at 1-800-273-8255.

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