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Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024
| Contributor Information
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Burnout and depression have become powerful foes to doctors who hope to be effective practitioners and enjoy a well-rounded life. A Medscape survey checked in on physicians who experience burnout and depression and learned how long the problem has lasted — and what they and their employers are doing about it.
In this report, gender is based on how physicians self-identified in our survey.
Some totals in this presentation do not equal 100% because of rounding.
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Physicians self-reported both depression and burnout less frequently than in last year's survey, after steady climbs through the worst COVID years. Still, Heather Farley, MD, an emergency physician and chief wellness officer at ChristianaCare in Wilmington, Delaware, says it's too early to make optimistic predictions, especially given other recent data that are more worrisome.
For example, she points to a Centers for Disease Control and Prevention report showing a significant increase in poor mental health days among healthcare workers.
"There's definitely an increase in national awareness in the healthcare profession, with more health systems investing in wellness infrastructure and hiring wellness officers," Farley says. "Unfortunately, the pandemic-related stressors have been replaced by new and exacerbated stressors in the form of financial pressures, which have many health systems making fewer people do more."
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
In last year's report as well, emergency medicine topped the list of percentage of specialists who said they felt either burned out or both burned out and depressed. Obstetricians, pediatricians, and family physicians also were near the top of the list last year.
"It's interesting to me that these are all front-line specialties delivering primary care either predominantly or frequently," notes Lisa MacLean, MD, a psychiatrist and chief clinical wellness officer with the Henry Ford Health System in Detroit.
Research also shows, MacLean says, that burnout among cardiologists and critical care physicians has declined recently after spiking during the pandemic.
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Why do more female than male physicians tell Medscape that they feel burned out? Realities both in the workplace and at home play a role, Farley says.
"Some of it has to do with different levels of resources for female physicians, such as fewer mentoring and sponsorship resources" than an average male doctor enjoys, she says.
"There are also cultural factors, like fewer women in leadership roles who can advocate for them, plus compensation disparities and fewer career-advancement opportunities," which can leave a physician feeling stressed. "Then also, there are challenges to work-life integration that disproportionately affect female physicians, who carry greater responsibilities for childcare and looking after aging parents."
"It's not easy to close that gap" of female doctors more often reporting burnout than men do. "We have much work to do," notes Farley.
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Male and female physicians at virtually identical rates attributed burnout and/or depression to the job entirely or most of the time (83% combined).
"I suspect that they are equally impacted by the different burnout drivers that exist in healthcare," MacLean says. "However, overall we know that women experience burnout more than men do.
"So, if the question had been oriented to burnout arising from their personal lives, I think there would have been a differentiation. A lot of families are still set up in traditional ways where women handle more of the childcare and household issues on top of their job stress."
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
The frequency with which doctors said they have felt burned out for at least 13 months rose compared with last year's response (62%).
"I'm not surprised that physician burnout has a long duration," Farley comments. "Burnout is primarily an occupational phenomenon, which is why a physician … often will go on vacation and return feeling as burned out as before. When the major contributors to their burnout are in the work environment, that's not going to change when they go on vacation."
Burnout also "is a lagging indicator," she adds, which means the workplace issues have been in place even longer.
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
The top three factors chosen most often from a list given in Medscape's survey have held steady for several years. Bureaucratic tasks also topped the list, at 61% of respondents, in last year's report.
"There is always going to be bureaucracy that creates barriers to providing quality care — always," MacLean predicts. "Even if a health system has an overarching program to minimize administrative tasks, there will be granular rules at the unit level that add to the burden.
"We do need to strive to reduce those tasks as much as possible, and the buzz I keep hearing is that AI to streamline workflow and allow physicians to work at the top of their license will be the next big step forward."
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
A greater share of both male and female physicians said burnout has a strong or severe impact on their lives (ratings 4 or 5) than little to no impact (ratings 1 or 2).
"I'm not surprised at the percentage who say they may leave medicine. A national survey shows 30%-40% of physicians say there's a likelihood they'll leave their practice in the next 2 years," says Nigel Girgrah, MD, PhD, a gastroenterologist/internist and chief wellness offer at Ochsner Health in New Orleans. "But only about a third actually do, and I would think the same would apply here."
Even so, Girgrah says, "it's disturbing how many doctors will leave FTE status or take similarly strong actions with their jobs to cope with burnout."
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
In last year's report, 65% of doctors answered yes to this question.
"First and foremost, it's important for physicians to recognize when they're struggling, to take a self-assessment and not just try to push through it," Farley suggests.
"I'm a huge proponent of coaching to help physicians figure out what steps they need to take to protect themselves and handle their current challenges. They should tap into resources like EAPs and peer support, and also share their struggles with family and friends. Nurture those relationships; don't let them languish."
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Around half of doctors felt that their employers weren't paying enough attention to burnout levels in their physician staff. "It is a big problem," Girgrah says.
"But I think you will see that percentage go down over the next few years. There's an increasing awareness among executives in healthcare that well-being is a leading quality indicator, if not the indicator" of favorable outcomes in patient care, staff turnover, and other vital areas.
Plus, the National Academy of Medicine's plan for healthcare workforce well-being "is starting to get some traction" with health system leaders, he says.
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
No predominant opinion among physicians emerged when Medscape asked whether openness with coworkers about their burnout levels could be productive.
"There's been a degree of learned cynicism or skepticism among physicians" in terms of how much real help to expect from the workplace with professional burnout, Girgrah believes. And coworkers might not be regarded much differently in that realm than CEOs and HR directors would, he says.
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Doctors more frequently said they turn to more positive coping mechanisms like exercise, family/friend time, better sleep, and quality contemplative time than to more indulgent solutions like junk food, drinking, and overeating.
"The pandemic appropriately forced us to focus on thinking about positive coping mechanisms," Girgrah says. "Meanwhile, there has also been more discussion around boundary setting: Are you using your vacation time and taking breaks during the day? And more execs have stopped sending emails after 5 PM."
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
This list largely resembles that in last year's report, when raising pay and adding schedule flexibility also were in the top three.
"Having enough support staff to help deliver quality care is key in fighting physician burnout," MacLean observes. "Many organizations have struggled to hire qualified support staff since the pandemic. Losing just one key staffer can affect the well-being of the entire team."
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Physicians more often opted to take control of the problem by reducing their work hours than to approach their employer to take steps to minimize burnout.
"This tells me that many of our physicians don't feel a sense of autonomy or agency in terms of impacting the work environment," Girgrah says. "They are taking actions that rely on themselves."
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Since our 2018 report, the rate of clinical depression that physicians reported rose, while the percentage of colloquial depression was around the same. This year, women who were experiencing depression were likelier than men to describe it as clinical (32% vs 23%). Men more often called their depression colloquial (68% vs 58% of women).
However, Farley feels that many doctors "are not great at self-diagnosis" and not reliable at parsing between less and more severe forms of depression. For that reason, physicians would be better off immediately seeking treatment or counseling than gauging their depression as too minor for the effort, she says.
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Again in this year's survey, physicians chose job-related burnout most often as a factor behind depression, and at a rising rate (64% of them listed it among their top 3 stressors last year).
"Job burnout is not the same as depression but it's a major risk factor for developing depression," Girgrah says. "There is some overlap.
"I think of burnout as an occupational syndrome; over time, the resulting exhaustion can lead to depression. Burnout reduces the ability to address mental health challenges at an earlier stage."
Also, when this survey was conducted in late 2023, world events were seen as less responsible for physician depression than in last year's report (43%).
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Female physicians were at most slightly more likely than men to say that being open with peers about their depression could bring positive results. The majority of both women and men found confiding with other doctors to be impractical.
Why? "There is still shame and stigma" about depression "that is a barrier," MacLean suggests. "Most physicians are high-achieving and driven people, and they really struggle with the attitude that they should be stronger than this, that they shouldn't need attention at all.
"That doesn't mean they wouldn't seek care. It's just that they wouldn't see confiding in a colleague to be helpful."
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Compared with our 2023 report (51%), physicians were less likely to feel that depression did not affect their patient relationships. They more frequently admitted that they easily become exasperated with patients (32% in 2023) and that their patient note quality suffered (19% in 2023).
It's possible that many of these doctors also are experiencing burnout, and that is influencing patient interactions more strongly than depression is, Farley suggests. "We know that burnout is associated with poor interactions with patients," based on research.
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
In last year's report, 51% of physicians said depression conveyed something negative about them personally; 41% worried that people would think less of them, and 26% said they considered depression to be a weakness.
"I do feel like there is a positive shift in attitudes even among the shame and stigma about depression," MacLean says.
She expressed concern about the 42% of physicians who worried about medical boards or employers learning about their depression. Efforts by the AMA and Lorna Breen Heroes Foundation to remove intrusive mental health questions from state licensing and credentialing applications have made significant progress, she noted.
But that progress seemingly was not reflected in doctors' replies to Medscape's survey.
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Since our 2022 report, the top three approaches shown here are each up several percentage points. Are physicians being more deliberate about tending to such happiness-supporting habits?
"Purely anecdotally," Girgrah says, "I see a lot more physicians from my health system at my gym after work than I ever saw during the pandemic. And our health system's on-site gym is getting a lot more traffic in the middle of the day.
"If it's a trend, it's a good trend to see."
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Physicians who said they had experienced burnout and/or depression were asked whether they had previously sought professional help or planned to do so.
A majority replied that they hadn't consulted a mental health professional before and wouldn't going forward.
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
Medscape Physician Burnout & Depression Report 2024: 'We Have Much Work to Do'
Jon McKenna | January 26, 2024 | Contributor Information
How You'd Like to Live, What That Will Cost: Medscape Physicians Eye Retirement 2023 Report
Physicians of various ages reveal their financial goals for retirement and the personal and professional lifestyles they want to lead after practicing medicine.http://img.medscapestatic.com/thumbnail_library/docs-look-to-retire-rpt-2023.jpg
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