US Physicians Face Pandemic-Related Burnout, Disapprove of Work-Life Blending

Doctor sitting with head in hands
Researchers assessed the prevalence of burnout and satisfaction with work-life integration among US physicians at the end of 2021 compared with previous years.
Physician burnout is associated with decreased quality of care, turnover, and reductions in work effort.

Physicians in the United States experienced a significant increase in burnout and a decrease in satisfaction with work-life integration (WLI) during the COVID-19 pandemic, according to survey findings published recently in Mayo Clinic Proceedings.

Researchers conducted a survey of 2440 US physicians (43,299 physicians were invited to participate) from December 2021 through January 2022 to evaluate depression, professional fulfillment, WLI, and burnout. The participants from the 2021 survey were more likely to be younger and more likely to be women than participants from the 2020 survey.

Researchers found the mean depersonalization and emotional exhaustion scores to be higher in 2021 than in 2020, 2017, 2014, and 2011 (all P <.001).

Mean depersonalization scores (2020 mean, 6.1; 2021 mean, 9.8) reflected a 60.7% increase (P <.001), and mean emotional exhaustion scores (2020 mean, 21.0; 2021 mean, 29.1) reflected a 38.6% increase (P <.001).

Overall, 62.8% of physicians manifested burnout at least once in 2021 compared with 38.2% in 2020, 43.9% in 2017, 54.4% in 2014, and 45.5% in 2011 (all P <.001). There was significant variability by specialty in these trends, and the data suggested the increased risk for burnout and work-life conflict among women physicians was exacerbated by the COVID-19 pandemic. Multivariable analysis revealed that in 2021, physicians practicing family medicine, general pediatrics, and emergency medicine faced increased risk for burnout after adjusting for professional and personal characteristics.

Satisfaction with WLI declined to 30.2% in 2021 compared with 46.1% in 2020, 42.8% in 2017, 40.9% in 2014, and 48.5% in 2011 (P <.001). Using multivariable analysis to pool responders from these surveys, adjusting for sex, age, hours worked per week, specialty, and practice setting, 2021 responders were less likely to be satisfied with WLI compared with 2014 responders (odds ratio=0.66; 95% CI, 0.58-0.75). Responders from 2020, 2017, and 2011 were more likely to be satisfied with WLI compared with those from 2014.

Mean professional fulfillment scores decreased 17.6% from 6.49±2.22 in 2020 to 5.38±2.33 in 2021. The proportion of physicians with a favorable professional fulfillment score decreased from 40.0% in 2020 to 22.4% in 2021. They also found the proportion of physicians who would choose to become a physician again if they could revisit their career choice dropped to 57.1% in 2021 compared with 72.2% in 2020, 68.5% in 2017, 67.0% in 2014, and 70.2% in 2011.

Mean scores for depression increased 6.1% to 52.59 in 2021 from 49.54 in 2020 (P <.001).

Limitations of the study include response bias with low participation rate and lack of a comparative sample of the general US workforce from 2021.

Study authors concluded, “A dramatic increase in burnout and decrease in satisfaction with WLI occurred in US physicians between 2020 and 2021.” They suggest the modest differences in mean depression scores signifies the increase in stress was overwhelmingly work-related.

Reference

Shanafelt TD, West CP, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life integration in physicians over the first 2 years of the COVID-19 pandemicMayo Clin Proc. Published online September 2022. doi:10.1016/j.mayocp.2022.09.002

This article originally appeared on Psychiatry Advisor

References:

Shanafelt TD, West CP, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life integration in physicians over the first 2 years of the COVID-19 pandemic. Mayo Clin Proc. Published online September 2022. doi:10.1016/j.mayocp.2022.09.002