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Physician Burnout Continues at Record Levels, One-Third Feel 'Hopeless'

— Stigma surrounding seeking care for mental health persists, survey shows

MedpageToday
A photo of a tired looking mature female physician sitting at her desk rubbing her face.

The state of physician wellbeing remained low 2 years into the pandemic, survey data showed.

One in three physicians reported feeling hopeless or that they had no purpose, according to the second part of the from the nonprofit Physicians Foundation.

For the second year in a row, 60% of 1,509 physicians who completed the online survey said they often feel burned out, compared with 40% before the pandemic.

"Burnout remains at record levels despite the worst parts of the pandemic being behind us," Gary Price, MD, president of the Physicians Foundation, said in an email to app.

"Physician burnout has not gone unnoticed by our profession or by society, and yet what we found most equally concerning is that there is still rampant stigma surrounding seeking mental health care and that underlying system barriers are preventing physicians from accessing mental health care," Price observed.

The share of physicians with self-harm thoughts grew from 7% in 2021 to 11% in 2022, the study found. Overall, 19% sought medical attention for a mental health problem, up from 14% in 2021.

"We knew stigmatizing and intrusive mental health questions on medical licensure and hospital credentialing applications was a barrier, but the survey reinforced how bad it is," Price said.

"Nearly four in 10 physicians were either afraid or knew another physician fearful of seeking mental health care because of questions asked in medical licensure, credentialing, or insurance applications," he pointed out.

In all, 80% reported stigma surrounding mental health and mental health care-seeking by physicians.

Survey responses also showed:

  • 58% of physicians experienced inappropriate anger, tearfulness, or anxiety
  • 46% have withdrawn from family, friends, and co-workers
  • 17% increased use of medication, alcohol, or illicit drugs
  • 11% began use of medications, alcohol, or illicit drugs

In the past year, a higher percentage of employed physicians, physicians 45 and younger, and female physicians had inappropriate feelings of anger, tearfulness, or anxiety; withdrew or isolated themselves from family, friends, and co-workers; and felt hopeless or that they had no purpose.

"For too long, there has been an assumption that physicians just need to be more resilient, and approaches to eliminating burnout have focused on this approach," Price said.

About two in 10 physicians found their hospital or health system to be "very or somewhat" helpful to their mental health and wellbeing over the past year. Four in 10 of physicians saw their medical practice or group as "very or somewhat" helpful.

By contrast, a majority of physicians rated family (85%), friends (81%), and colleagues (62%), as helpful to their mental health and wellbeing.

In his email, Price highlighted five from the nonprofit All-In coalition that could be initiated within 3 months to help physicians and other healthcare workers.

Peer support programs and mental health counseling were among those actions. In the Physician Foundation's survey, 65% of respondents reported that confidential therapy and counseling or phone support was "very or somewhat" helpful and 57% said they felt the same about peer support groups.

More than half of physicians said their workplace "rarely or never" implemented a majority of evidence-based actions intended to support physicians, such as removing low-value work, giving physicians more flexibility and autonomy to improve the patient experience, and eliminating insurance approvals.

The survey was conducted from June 24 to July 3, 2022, following emails to physicians using a Medscape database. The sample represents the site's online population with a margin of error of ±2.523% at a 95% confidence level.

Approximately 42% of respondents were women and 58% were men; 62% were white, 24% were Asian, 6% were Hispanic, and 5% were Black. Most (57%) were specialists and 43% were primary care physicians.

Half of respondents were 36 to 55 years old. About half (51%) were employed by a hospital, 20% worked for a physician-owned medical group, and 23% were independent.

In March, President Biden signed the Dr. Lorna Breen Health Care Provider Protection Act into law to reduce and prevent suicide, burnout, and mental and behavioral health problems among healthcare workers. Breen was a frontline physician at NewYork-Presbyterian Allen Hospital in New York City who died by suicide in April 2020.

A conducted by the All-In group found that 17 states have removed "intrusive mental health questions" as of August 24, but another 33 states and the District of Columbia have not, Price noted.

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    Shannon Firth has been reporting on health policy as app's Washington correspondent since 2014. She is also a member of the site's Enterprise & Investigative Reporting team.