Physician Burnout Is Not Being Extinguished and Is Dangerously Spreading to Parents

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

“I have reached my limit for the BS I can take from the hospital administration, insurance companies, and demanding patients” - Anonymous Physician

Today is Labor Day, and physician labor still has a major challenge in burnout, at least according to the timely Medscape 2024 Physician Burnout & Depression Report.¹ The physician quote above appeared at the beginning of the report.

It has been about 5 years since I coedited a book on how psychiatrists could help combat physician burnout.² Since then, the COVID-19 pandemic occurred and remitted over a year ago, though less severe infections are still common.

The new data indicates that burnout has returned to the overall epidemic rate from right before COVID, a bit of an advance because it had increased by a couple of percentage points during the pandemic. Perhaps, some success can also be claimed as the rate could have gone even higher. Nevertheless, it clearly suggests that current efforts to improve systems with, say, Chief Wellness Officers is falling short.

The rate among psychiatrists is 41%, on the lower range but nothing to be particularly proud of, while emergency physicians are the most burned out by far in this survey, at 63%. Other striking findings are:

• A 10% higher rate of burnout among female physicians
• The burnout has lasted over 2 years for almost half of the reporting physicians
• Over a third are thinking of leaving their practice within 2 years
• Half think their administrators do not recognize their burnout
• About a quarter have symptoms consistent with clinical depression
• Patients are adversely affected
• Most do not go for formal help due to perceived stigma

The main cause seems to be bureaucratic blocking of what we know how to best help and heal, as profit trumps quality of patient care.

As usual, there are limitations with the survey conducted by Medscape, yet the apparent lack of progress in reducing physician burnout continues. With the apparent decrease of attention to it in our medical organizations, it is now as if this is becoming normalized and accepted as being part and parcel of being a physician in this business-controlled practice of medicine, a kind of learned helplessness. In many ways, we physicians parallel the historical labor movement in our lack of control of the conditions of our work.

Speaking of general laborers, burnout has also been spreading to other workplaces, though physicians still have the highest rates. Not only that, but parents are rapidly catching up to the burnout race, as pointed out in the first sentence of this news story on August 28: “Parents are feeling overwhelmed and burned out by the ‘dizzying pace’ of daily life.”³ As a response, Surgeon General Vivek Murthy has come up with an advisory warning, as we now appreciate how much work parents do. Now, the rate of both parents working at jobs is added to both raising any children. In his advisory, he finds that that over 40% of parents report they have so much undue stress that they cannot function adequately most days. Traditionally, grandparents have helped in child rearing, but nowadays so many families are split up geographically, making that much harder to do.

As worrisome rates of burnout have spread from physicians to workers and now to parents, we are left with this Biblical question:

“Can a blind man guide (another) blind man? Will they not both fall to a hole in the ground?” (Luke 6:39-45)

I have not yet heard either political party campaign emphasize that we need to address this mental health challenge. May Labor Day not only be a brief respite from our country’s burnout challenge, but inspire us to increase and spread our anti-burnout efforts.

Along with his prior warning about our loneliness epidemic, the Surgeon General’s eyes are open and seeing that the state of our collective well-being has been deteriorating right in front of his and our eyes. Can he, as well as our upcoming political and professional leaders, help lead us to renewed passion for our workplaces, childrearing, and relationships?

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.

References

1. 2024 Physician Burnout & Depression Report. Accessed August 29, 2024. https://www.medscape.com/slideshow/2024-lifestyle-burnout-6016865#1

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

3. Gumbrecht J. Parental stress is a significant public health issue, surgeon general says in new advisory. CNN. August 28, 2024. Accessed August 29, 2024. https://www.cnn.com/2024/08/28/health/surgeon-general-parent-stress-wellness/index.html