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Burnout, dissatisfaction drive 1 in 5 physicians to plan on reducing work hours

Survey results published in Mayo Clinic Proceedings reveal a significant level of discontent among physicians, with many considering scaling back or leaving practice altogether.

The primary sources of frustration are the burden of practicing medicine and dissatisfaction with electronic health records, according to the researchers.

“[HHS] projects a shortfall of 45,000 to 90,000 physicians by 2025, even after accounting for an influx of advanced practice health care professionals, as the U.S. population ages and the prevalence of chronic disease increases,” Christine A. Sinsky, MD, from the AMA, and colleagues wrote.

“The United States has begun to address this issue by increasing the flow of physicians into the workforce, establishing 11 new medical schools between 2001 and 2011,” they added. “The factors influencing the flow of physicians out of the workforce and the magnitude of this phenomenon are not fully understood.”

Between Aug. 28, 2014, and Oct. 6, 2014, Sinsky and colleagues conducted a survey to investigate how burnout, satisfaction with EHRs and work-life integration affect the career plans of U.S. physicians. The researchers contacted 35,922 physicians across all specialties and 6,695 completed the survey and were currently in clinical practice. Physicians were asked how likely they were to reduce clinical hours in the next 12 months and leave current practice in the next 24 months.

Data from the survey indicated that 19.8% of respondents reported that they would likely or definitely reduce their clinical works hours within the next year, noting reasons such as the desire to spend more time with family (28.6%) and frustration with work characteristics (26.2%), including Medicare and insurance issues.

In addition, 26.6% of physicians reported that they would likely or definitely leave their current practice within the next 2 years. These physicians reported plans to either retire (37.4%), pursue a different practice opportunity (35.2%), work as a health care administrator (9.7%) or pursue a different career (7.4%).

Physicians were more likely to intend to cut clinical work hours if they were burned out (OR = 1.81; 95% CI, 1.49-2.19), dissatisfied with work-life integration (OR = 1.65; 95% CI, 1.27-2.14) or dissatisfied with the EHR (OR = 1.44; 95% CI, 1.16-1.8). Burnout (OR = 2.16; 95% CI, 1.81-2.59), dissatisfaction with work-life integration (OR = 1.49; 95% CI, 1.17-1.89) and dissatisfaction with the EHR (OR = 1.57; 95% CI, 1.27-1.93) were also associated with physicians’ intentions to leave their positions within 2 years.

Burnout was the most influential factor for physicians intending to leave medical practice for a different career (OR = 5.79; 95% CI, 2.47-13.56).

“If physicians follow through on these intentions, they have the potential to profoundly worsen the projected shortage of U.S. physicians,” Sinsky and colleagues concluded. “Burnout, dissatisfaction with EHR and problems with work-life integration appear to be major factors influencing physician career plans. Concerted efforts are needed to address these issues at the national and organizational level to preserve the adequacy of the physician workforce.”

In a related press release, the AMA stated that these findings elucidate the “troubling” association between the growing issue of burnout, technology dissatisfaction and administrative fatigue and physicians’ career plans, as well as highlight the need for national policymakers and health care delivery institutions to develop a comprehensive approach to address the problem.

“An energized, engaged, and resilient physician workforce is essential to achieving national health goals,” David O. Barbe, MD, MHA, president of AMA, said. “Yet burnout is more common among physicians than other U.S. workers, and that gap is increasing as mounting obstacles to patient care contribute to emotional fatigue, depersonalization and loss of enthusiasm among physicians.”

“The AMA is urging Congress, hospitals and health plans to recognize the coming crisis as an early warning sign of health system dysfunction. America’s physicians are the canary in the coal mine,” he continued. – by Alaina Tedesco

Disclosure: The authors report that funding was provided by the Mayo Clinic Department of Medicine Program on Physician Well-being.