Burning Out About Physician Burnout

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

“Only a sociopath could practice as an employee of a large health system and not be burned out. Anyone who cares about patients is doomed to burnout.” - Anonymous Physician

Today is the first day of Black History Month, but I interrupt my series on the Memphis Scorpions tragedy for a pop-up column on the breaking news about us. The annual Medscape Psychiatry report on physician burnout just came out: “‘I Cry but No One Cares’: Physician Burnout & Depression Report 2023.”¹ Today, let’s just focus on the burnout part.

The news is not good. Not that any physician would likely be surprised, but the epidemic rate of physician burnout has escalated once again in this annual survey, now up to 53% collectively. It was 42% in 2018.

Emergency medicine tops the list at 65% and psychiatry is up to 47%. Women are up to 63%, while men are at 46%.

Out of the perceived contributing factors, too many bureaucratic tasks tops the list at 61%, with lack of coworker respect, lack of patient respect, and lack of control up there, too. Half rate the burnout as severe. That wildfire-like severity seems likely to even burn out anything in its path, including some of the benefits of any work/life balance.

Sure, the study methodology is once again suspect. Sure, we can blame the pandemic. Sure, we can point to staff shortages. Sure, we can still hope that Chief Wellness Officers can help, and maybe they have. Maybe the rate would be even higher without them. We can hope that the American Psychiatric Association will come up with something innovative.

By now, it appears that documenting the problem is insufficient, including the book I helped coedit.² I am even feeling burned out about writing about burnout, which is also sweeping across other workplaces in the United States.

What is gaining more traction is unionizing, as 50% of the physician responders now recommend. If this report is generalizable, how else do you now counter a business-controlled field that is hurting you and your patients? These businesses are not just the transformation of the old for-profit managed care companies,³ but also the hospital systems that have risen to challenge them.

What else is there to do?

Perhaps the book some of my other colleagues and I have begun—The Eastern Religions, Spirituality, and Psychiatry—provides another alternative. If physician burnout is becoming normalized, could joining an eastern and western psychological approach to the inevitable suffering be the way to go?⁴ Shall we follow the song from the movie “Frozen” and “Let It Go”?

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times™.

References

1. Gliadkovskaya A. 'I cry and no one cares': Medscape survey shows doctor burnout, depression is getting worse. Fierce Healthcare. January 30, 2023. Accessed February 1, 2023. https://www.fiercehealthcare.com/providers/new-medscape-report-physician-burnout-depression-shows-its-getting-worse

2. LoboPrabhu S, Summers R, Moffic HS. Combating Physician Burnout: A Guide for Psychiatrists. American Psychiatric Publishing; 2019.

3. Moffic HS. The Ethical Way: Challenges & Solutions for Managed Behavioral Healthcare. Jossey-Bass; 1997.

4. Epstein M. The Zen of Therapy: Uncovering a Hidden Kindness in Life. Penguin Press; 2022.