By Janet Settle MD
In a cross-sectional study of physicians from all specialties (Dyrbye, 2013), the levels of burnout, professional and personal satisfaction were measured in early (practicing 10 years or less), mid (practicing 11-20 years), and late (21 + years) career stages. Burnout, measured using the Hamburg Burnout Inventory, is characterized by exhaustion (mental and physical), detachment and/or depersonalization, and reduced personal accomplishment. A whopping 22.5% of the physicians in this study reported that they were considering leaving medicine in the next 24 months for reasons other than retirement!
|Statistically significant findings (p<.001). Dyrbye, 2013.|
|Early (0-10 yrs)||Mid (11-20 yrs)||Late (20+ yrs)|
|work load||worked most hours and took most call|
|satisfaction||lowest satisfaction with being a physician||lowest satisfaction with specialty choice|
|work-life issues||highest personal life conflicts||lowest satisfaction with work-life balance|
|symptoms of burnout||highest rate of depersonalization||highest rate of emotional exhaustion and burnout|
|% considering leaving medicine in the next 24 months for reasons other than retirement||4.8%||12.5%||5.2%|
Is burnout is a unique entity or a type of depression? Wurn et al (2016) found significant overlap. A subgroup of those with burnout also reported depression, suicidality and insomnia in a sample of 40,093 physicians.
In an Isreali study of physician burnout (Ben-Itzhak, 2015), the two significant factors associated with burnout were worry and a sense of existential meaning derived from work.
Comments: The med-check “chemical imbalance” model of psychiatry is a source of disillusionment for many. I know it was for me. The literature supports a variety of interventions for physician burnout including training in heart rate variability, mindfulness, and compassion.
In our experience at Psychiatry MasterClass, addressing the physiologic, spiritual, environmental and relational root causes of patients’ symptoms is another remedy for physician burnout. Even though not all of my patients choose to order from the integrative medicine menu, having those choices available has restored my sense of meaning and my pleasure in practicing medicine.
Ben-Itzhak S. Sense of meaning as a predictor of burnout in emergency physicians in Israel: a national survey. Clin Exp Emerg Med. 2015 Dec 28;2(4):217-225. eCollection 2015.
Dyrbye LN. Physician satisfaction and burnout at different career stages. Mayo Clin Proc. 2013 Dec;88(12):1358-67. doi: 10.1016/j.mayocp.2013.07.016.
Wurm W1. Depression-Burnout Overlap in Physicians. PLoS One. 2016 Mar 1;11(3): e0149913. doi: 10.1371/journal.pone.0149913. eCollection 2016.