Physician Burnout and Bias

We pay close attention to how physicians feel about their jobs because this can affect not only the quality of care they deliver but also what they demand economically in return for performing increasingly thankless and over-regulated work.  Medscape issues its 2016 Lifestyle Report, which surveyed 15,800 doctors across 25 specialties.  (Medscape Report)  Burnout for purposes of the survey was described as loss of enthusiasm, cynicism, no sense of accomplishment–sounds good!  All specialties reported high rates of burnout, more than half were over 50%, and every specialty reported burnout rates above last year’s rates.  Critical care, urology and ER led the way at 55% but several others were right behind.  Mental health, endocrinology and ophthalmology had the lowest rates.  Severity of burnout was also reported to be up across all specialties.  Female physicians report higher levels of burnout than do male ones.  Primary causes for burnout were cites as work hours, bureaucracy, computerization of practice, concerns about malpractice and malpractice insurance costs, income and lack of patient appreciation.  Whether or not physicians report being very or extremely happy at work and at home is basically unrelated.  The highest happiness ratings at work were reported by dermatologists, opthalmologists and mental health physicians, but only around 37% of these doctors report being very or extremely happy.  Internal medicine, critical care, urology and rheumatology have the lowest number reporting happiness with work.  Most doctors report feeling financially secure, but a significant minority are stressed with little hope of financial improvement.

The survey also asked about the presence of bias toward patients and most doctors reported some bias, with 62% of ER physicians doing so and only 48% of psychiatrists.  The primary reasons for bias were patients presenting emotional problems, overweight patients and intelligence (not clear whether doctors don’t like patients who are too smart or too dumb).  Race and gender rated very low as a reported source of bias.  A very small number said their bias affected treatment decisions, and among those who did, in some cases the effect was negative and in some positive.  Doctors who said they were socially liberal had the highest rates of bias.  Younger doctors tended to be more likely to overcompensate by increasing treatment when they perceived bias than did older ones.  Overall the survey should heighten the need to figure out how to address physician job satisfaction.