There Is a Little Something to Be Fired Up About Physician Burnout

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

It is not much, and it may even by an insignificant change or artifact of the methodology, but there may be a hint of some reversal in the epidemic of burnout in physicians in general and psychiatrists in particular. In the annual Medscape Physician Burnout and Depression Report 2024 that recently came out, overall physician burnout fell for the first time since 2020, falling from 53% in 2023 to 49%.¹

It appears that more attention to personal wellness outside of work may be the key factor. That factor includes focusing on work-life balance, hobbies, and a willingness—and even desire—to take a pay cut for more personal opportunities outside of work.

Psychiatrists remain at the same lower level, 39%, whereas emergency medicine is still highest by far, at 63%. More women than male physicians still report burnout.

Bureaucratic tasks are viewed as the major contribution to burnout, which is where the rub lies. Although disengaging systems which block physician healing potential seem to be by far the most powerful influence to burnout, little improvement in that is reported by physicians in this survey.

The bottom line is that there may be some appreciation for better self-care, which is important regardless of burnout, but it has significant limits. Self-care does not seem to improve our systems. At its worse, self-care and enhanced resilience may cause us to ignore our systems and just plow on.

As long as our health and mental health care systems emphasize profits and savings over quality of care and physician well-being, major changes for the better is unlikely.²

What new strategy may help? We can note the beginning of physicians involved in strikes, not only in the United States, but globally.³ However, such strikes are risky in themselves for physicians and patients, given the possibility of unmet patient needs, labor laws against physician unionization, and the need to protect physicians from punitive actions.

In general, it seems like it will take involvement of all major stakeholders to improve our current systems of care and to substantially reduce physician burnout. Certainly, the public is one of the major stakeholders and must be concerned about the burnout rate in the emergency services, both general medical and psychiatric, that any citizen might turn out to need.

In any of the health care debates and nomination processes since the election, little has been conveyed about the burnout risks. Moreover, since burnout can be insidious, it still requires ongoing attention at all levels of our health care systems.

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 presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. 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. Medscape Physician Burnout and Depression Report 2024. January 26, 2025. Accessed February 13, 2025. https://www.medscape.com/slideshow/2024-lifestyle-burnout

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

3. Ramesh T, Shachar C, Yu H. Striking a balance - advocating physician collective-bargaining rights and patient protections. N Engl J Med. 2025;392(3):209-211.