Experts agree – doctor burnout is a public health crisis. Importantly, doctors currently report crisis levels of work-related burnout, defined as long-term, unsolvable job stress that leads to exhaustion and feeling overwhelmed, cynical, detached from the job, and unfulfilled. Unsurprisingly, when doctors experience burnout, their health, as well as ours, is at risk.

How widespread is doctor burnout?

As you likely know, COVID-19 placed an extreme burden on doctors and healthcare systems. Studies showed that, worldwide, doctors (and other healthcare workers) providing frontline care experienced high rates of stress, anxiety, depression, and PTSD.

For instance, in a 2022 survey by The Physician’s Foundation, 60% of doctors reported they often have feelings of burnout. And 60% reported having inappropriate feelings of anger, tearfulness, or anxiety. Slightly more positively, in a 2022 Medscape survey, 47% of responding doctors said they were experiencing burnout. Additionally, one study found that overall, 63% of doctors had at least one manifestation of burnout in 2021.

Certainly, the first year of COVID-19 was extremely stressful for doctors. However, the ongoing prevalence of COVID-19 has depleted healthcare workers’ emotional reserves, causing many to leave the profession.

Shockingly, 117,000 doctors left the workforce in 2021, along with 217,000 other healthcare workers, with retirement, burnout, and other pandemic stressors to blame. This large loss of doctors and other providers left many healthcare systems unable to maintain optimal staffing levels, adding to the burden and stress for the remaining doctors and other providers.

Although COVID-19 caused, and continues to cause, a great deal of stress to doctors, there were concerning levels of work-related distress among US doctors before the pandemic.

Doctors were burned out before COVID-19.

In a 2019 Medscape survey of 15,000+ doctors in 29+ specialties, 44% of doctors described themselves as burned out. Additionally, 11% reported feeling down, blue, or sad, while 4% report being clinically depressed.

The survey found the following specialties had the highest percentage of burned out doctors:

48% – Critical care doctors.
48% – Neurologists.
47% – Family medicine.
46% – OB/GYN.

Additionally, a 2018 survey of 8,770+ doctors by The Physicians Foundation found that doctors have low morale and high stress. The survey findings include:

78% stated they sometimes, often, or always experience feelings of burnout.
55% described their morale as somewhat or very negative.
46% planned to change career paths.
24% reported feeling overextended and overworked.

Burnout takes an emotional toll on doctors.

As you’d expect, burnout can lead to serious mental health issues for doctors. In fact, the 2022 Medscape survey found that 24% of doctors reported clinical depression (classified as severe depression lasting some time), and 64% reported “colloquial” depression (feeling down, blue, or sad). Moreover, in the US, doctors have the highest suicide rate of any profession. And doctors end their own lives 2 times more often than the general population.

What causes doctor burnout?

As a society, we demand more of our doctors than ever before. Long hours, time-squeezed appointments, electronic health records, increased demand, and excessive workloads have created a difficult work environment.

The 2018 report “Crisis in Health Care: A Call to Action on Physician Burnout” notes that many doctors feel that the demands of documentation and/or quality measures can negatively impact the care they provide. Moreover, many doctors feel the daily demands of their profession are at odds with their commitment to healing and providing care. For example, doctors may struggle to meet their patients’ needs, due to conditions beyond their control, such as patient poverty, lack of insurance authorization, and unreasonably short appointment times.

Finally, doctors literally have our lives in their hands, a responsibility that can weigh heavily under the best of circumstances.

In the 2019 Medscape survey of 15,000+ doctors, doctors cited many reasons for feeling burned out, including:

59% – Too many bureaucratic tasks (e.g., paperwork).
34% – Spending too many hours at work.
32% – Increasing use of electronic health records and other digital tools.
30% – Lack of respect from administrators/employers, colleagues and/or staff.
29% – Concern regarding income.

Doctors are busy!

In the 2018 survey by The Physicians Foundation, doctors (across all specialties) reported the following workloads:

Most doctors see a lot of patients each day.

18% see 0-10/day
40% see 11-20/day
28% see 21-30/day
9% see 31-40/day

Doctors spend many hours on non-clinical tasks.

In addition to seeing patients, doctors must spend time on a slew of other tasks. For example, doctors must enter data into EHRs, check test results, read reports from specialists, coordinate care, respond to email and phone messages, and prescribe medications.

In the 2018 survey by The Physicians Foundation, doctors reported spending many hours each week on non-clinical paperwork, as follows:

25% – 0-5 hours
29% – 6-10 hours
19% – 11-15 hours
12% – 16-20 hours
6% – 21-25 hours

Addressing inequalities adds to doctor burnout.

Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Examples of SDOH include access to nutritious food and physical activity opportunities, language and literacy skills, pollution, job opportunities, and discrimination.

In a 2022 survey by The Physician’s Foundation, 60% of doctors reported they don’t have the time or ability to address their patients’ SDOH, adding to feelings of burnout:

83% believe that addressing patients’ SDOH contributes to doctor burnout rates.
63% report that personally, they often have feelings of burnout when trying to address their patients’ SDOH.

Doctors must stay on top of recent research and innovations.

To provide the best, most up-to-date care possible, doctors must continue learning throughout their careers. But with tens of thousands of treatments and medical devices available, plus over 20,000 clinical trials currently recruiting patients in the US alone, keeping up with the expansive amount of medical literature published each year is seemingly impossible.

To gauge doctors ability to keep up with new developments, Doximity surveyed 600 doctors across five specialties: oncology, neurology, cardiology, endocrinology, and gastroenterology. Although 95% expressed interest in learning about new trials, treatments, or procedures, 68% felt overwhelmed by the amount of information to keep up with.

Interestingly, oncologists were the most likely to report feeling overwhelmed by the amount of new research, clinical trials, products, treatments or procedures to keep up with. Additionally, oncologists were more likely to sacrifice free time to further their knowledge.

Simply put, keeping up with the most innovative treatments is another stressor for already stressed doctors.

Primary care doctors are particularly burned out, stressed, and overloaded.

Although doctors of all types feel burned out, stressed, and overloaded, primary care physicians (PCPs) are particularly impacted.

A 2022 multi-nation survey by The Commonwealth Fund, found widespread stress and burnout among PCPs. For PCPS in the US, the key results are as follows:

63% of PCPs up to 55 years of age, and 54% of those 55+ years old, reported their jobs were “very stressful” or “extremely stressful”.
50% of PCPs under age 55, and 39% of those 55+ years old, reported signs of burnout.
45% of PCPs 55+ years old reported they would stop seeing patients within the next three years.

The findings confirms prior research that shows that younger doctors seem to experience burnout at significantly higher rates compared to older doctors. Unfortunately, the large exodus of older doctors will leave us with a primary care workforce made up of younger doctors who are more stressed, and more burned out.

Here are some of the reasons PCPs feel burnout and stress:

PCPs care for large numbers of patients.

In general, many PCPs feel they should have a maximum of 1,000 patients under their care, or less if most of their patients are elderly or have complex conditions. However, in order to meet overhead costs, most PCPs have 2,500 or more patients under their care. That’s a lot of patients to keep track of!

Appointments are time-squeezed.

Importantly, the insurance industry has tight reimbursement standards for PCPs. In the current fee-for-service model, PCPs may have to see 24-25+ patients/day to maintain their salary. Therefore, PCPs can only allot 15-20 minutes for each office visit, which actually translates to only 8-12 minutes of “face time” per patient.

Certainly, 15-20 minutes is not enough time for any patient with multiple chronic illnesses and/or a complicated medical history. Additionally, these short appointments are generally inadequate for patients with vision, hearing, or cognitive impairments.

Unsurprisingly, experts believe time constraints play a key role in burnout among primary care doctors.

PCPs are overwhelmed by administrative tasks.

In addition to appointments with patients, PCPs spend more time than ever on documentation and administrative tasks. In a 2021 Medscape survey, internal medicine doctors (PCPs for adults) report spending on average 19.7 hours per week on paperwork and other administrative tasks.

This ever-increasing administrative burden can lead to burnout among PCPs.

PCPs don’t have enough hours in the day to do everything required.

Alarmingly, a recent study found that PCPs would need 26.7 hours every day to see an average number of patients while following national recommendation guidelines for preventive care, chronic disease care, and acute care.

How could doctor burnout impact your health?

Cleary, we should all be concerned about the high level of doctor burnout, as it can impact our doctors and their abilities to provide care.

The quality of care may suffer when doctors are burned out.

Doctor burnout can increase medical errors and impact the quality of care you receive.

The 2022 international study (including the US) by The Commonwealth Fund found that primary care doctors who experienced stress, emotional distress, or burnout were more likely to report that the quality of care they provided declined during the pandemic.

Consider these additional findings:

A 2021 study found that burned out doctors are twice as likely to be involved in a patient safety incident, based on records from 239,000+ doctors across America, Europe and the UK.
2018 research linked burnout to medical errors for all specialties, finding that doctors who report signs of burnout are twice as likely to have made a medical error in the previous three months.
In a 2014 large national study, doctor burnout was associated with major medical errors.
In 2008, an anonymous survey of US surgeons found that major medical errors (as reported by surgeons) were strongly related to a surgeon’s degree of burnout and their mental quality of life.

Additionally, in the 2019 Medscape survey, among the doctors who reported depression, 47% reported no impact on their interactions with patients. However, others reported the following negative impacts:

26% – Being less motivated to be careful while taking notes about their patients.
14% – Making errors they might not ordinarily make.

Doctor burnout can impact our relationships with our doctors.

Clearly, if your doctor is burned out, you may find it difficult to establish, or maintain, a pleasant relationship, which can be an important part of getting the best care and outcome possible. In fact, in a 2010 Consumer Reports survey, doctors reported that a strong doctor-patient relationship is the most important thing a patient can do to get better medical care. Furthermore, 76% of respondents stated that strong relationships help patients “very much”. Simply put, doctor-patient rapport has important effects on a patient’s physical health.

And unsurprisingly, doctor burnout can also impact patient satisfaction. For instance, research in primary care settings shows a significant correlation between reduced patient satisfaction and doctor burnout.

For more information, read Why are Doctor-Patient Relationships Vital?

Widespread doctor burnout will make it harder to access medical care.

If you’ve been to an emergency room lately, you know how crowded they have become, with waits of 4-8 hours common. Unfortunately, hospitals are so full and labor shortages are so severe that no one expects it to get better anytime soon. And if you’ve tried to find a new doctor lately, you may have found it difficult to find a doctor who is taking new patients.

As mentioned above, the combination of retirement, burnout, and COVID-19 stressors lead to 117,000 doctors leaving the profession in 2021, representing over 10% of the 1,067,871 doctors practicing in the US (as of August 2022).

Scarily, this is a trend that may continue for years. A 2021 survey of more than 2,500 US doctors by Medscape found that many doctors are interested in career changes:

20% had considered leaving their current job to switch to nonclinical positions.
80% are actively exploring other career options.
34% stated that general burnout was the top reason for wanting to switch jobs.
- 7% stated that burnout related to COVID-19 was the top reason for wanting to switch jobs.
20% wanted to work fewer hours.

The large exodus of doctors in 2021 adds to an already growing concern about doctor shortages. According to a 2021 report from the Association of American Medical Colleges, the US faces a projected shortage of between 37,800 and 124,000 doctors within 12 years.

Currently, doctor shortages vary by specialty, with primary care the largest area of concern. Other specialties which currently face large shortfalls are neurology, psychiatry, pulmonary, and critical-care medicine. Unsurprisingly, there is also a shortage of general surgeons in rural communities.

Unfortunately, the shortage of doctors will be hard to fix – only 20,921 doctors earned M.D. (Medical Doctor) degrees from US medical schools in 2021. Additionally, there were 7,416 graduates from US osteopathic medical schools in 2021.

Burnout can lead doctors to self-medicate – even while working.

Importantly, we should all be worried about the level of substance use among healthcare workers, including doctors, both on and off the job.

A July, 2022 APN (an organization that provides addiction treatment for healthcare professionals, veterans and athletes) anonymously surveyed 1,000 healthcare workers. The participants included doctors, nurses, nurse practitioners, physician’s assistants, pharmacists, social workers, dieticians, physical and occupational therapists and medical technicians.

The responses showed widespread job-related stress:

40% reported feeling anxiety or dread about going to work.
49% said they are either at their breaking point or looking for new work because of the stress and trauma they endure on the job.

Unsurprisingly, the responses indicate that doctors struggle more than other healthcare workers. Sadly, to cope with these feelings, some doctors turn to drugs and/or alcohol.

Shockingly, 1 in 7 doctors (14%) admitted to consuming alcohol or using controlled substances while at work!

Additionally, 17% of doctors said they drink alcohol or use controlled substances at least once a day, while 21% reported consuming alcohol or controlled substances multiple times per day.

What should you do about doctor burnout?

Understanding the stresses your doctors face can improve your interactions with a burned out doctor. For starters, treat your doctor the same way you want others to treat you. And cut them a little slack.

Fortunately, there are steps you can take to maximize your appointment time and your relationship with your doctor. Consider the following:

Be patient with your doctor. A little compassion from you goes a long way!
Prepare for appointments. Before you go, write down your “story”, including your symptoms, when they appeared, triggers, etc. And write down your questions.
Make sure you bring an updated list of all your medications – including over-the-counter.
Realize your doctor may not have had time to thoroughly review your history and notes from your other doctors.
Bring up your important issues/questions at the beginning of each appointment – don’t wait until the end of an appointment!
Although appointments times are limited, don’t be afraid to ask your doctor to repeat or rephrase anything you don’t understand.
Use a notebook. At home, keep track of signs, symptoms, and questions. At appointments, jot down all important information. Consider recording appointments with your phone – but ask your doctor for permission first.
Keep copies of all important documents (test results, etc.) together and organized, and bring them with you to all appointments.
If something doesn’t seem right, don’t feel afraid to speak up. Be the polite, squeaky wheel.
Don’t assume no news means good news. If you don’t get test results by an expected date, look on your doctor’s portal or contact the office for your results.

Is it time to switch doctors?

Although it’s hard to imagine any doctor not experiencing some level of stress, it’s possible that burnout can change your doctor’s demeanor and quality of care. If your doctor behaves unpleasantly, or you feel you are getting subpar care, it’s probably time for a new doctor. For more information on when to consider changing doctors, read my series on this topic: Part 1, Part 2 and Part 3.

And if you have complicated health needs, you might want to consider switching to a concierge practice where you will get more time with your doctor and more personalized care. For more information, read The Benefits of Concierge Medicine.

Learn more…

Unsurprisingly, nurses experience burnout as well. To learn more, read How Does Nurse Burnout Affect Patients?

Finally, even if your doctors don’t appear stressed or overworked, engaging in your care can help you get the best care and outcome possible. Read these blog posts to learn more:

Doctor Burnout Can Impact Your Health