Physician Burnout: Symptoms & Causes

Physician experiencing burnout symptoms and causes

Many professionals eventually feel burned out at some point in their careers. However, certain careers allow for the potential of burnout to be more of a possibility. If not addressed, burnout can lead to a variety of unwelcome personal and professional consequences and may even cause some physicians to leave the field. However, by recognizing the typical causes of burnout and avoiding them. Physicians in all specialty areas can continue to feel a great love for their jobs and can feel refreshed and revitalized even if they have been practicing medicine for decades.

Physician Burnout

Burnout for any professional refers to a feeling of utter exhaustion both physically and mentally. The individual may no longer feel as if he or she can meet the high demands of the job and may simply want to give up. While burnout is not technically a mental illness, it can lead to mental and emotional issues, such as depression and anxiety, if not addressed quickly.

Because of their jobs' huge demands, physicians are highly likely to feel burned out rather quickly in their careers.

Physician burnout includes a wide range of signs and symptoms, but many doctors describe it as feeling if their batteries are worn out or run down. They run out of energy because they have been using more energy than they have been giving back to themselves for too long of a time.

Burnout for physicians can include issues related to:

  • Physical
  • Mental
  • Emotional
  • Spiritual

Long-term stress eventually takes a toll on the body and mind.

While physicians may be able to continue working in this state for some time, they cannot provide the same level of care. The quality of care decreases, and they may experience overwhelming symptoms that make it impossible to continue working their usual schedules while providing high-quality patient care.

It can be hard to pinpoint the start of burnout or exactly what it is.

  • However, burned-out physicians typically begin feeling cynical about their work or their patients.
  • They may also feel physical exhaustion or frequent detachment from their work.

Today, the American Medical Association (AMA) is working to understand more about this problem, its causes, how it affects physicians, and how it can best be addressed.

Commonality

Plenty of research on burnout has been done in the past that continues today. All reports show that burnout is a huge problem for numerous physicians.

In fact, at any given time, approximately 33% of physicians are experiencing symptoms of burnout.

Reports also show that physicians in certain medical specialties experience higher levels of burnout than others. The specialties in this group include urologists, neurologists, nephrologists, and endocrinologists. Those with the lowest burnout rates include those working in public health and preventive medicine, ophthalmology, and orthopedics.

Medscape performs regular surveys of physicians for burnout. While its 2013 survey showed that only 39.8% of physicians felt burned out, that number went up to 46% in 2015 before falling to 42% in 2020.

Physician burnout is a constant problem that must be addressed for the good of these professionals as well as their patients.

Negative Consequences

Unfortunately, physician burnout involves much more than simply feeling stressed.

When these caretakers feel as if they can no longer cope, they may turn to drugs, alcohol, or other problematic coping measures. If the stressor persists, there is even a potential for suicidality. In fact, suicide rates are far higher for physicians than they are for individuals in most other careers.

However, even when suicide is not an issue, those experiencing burnout are frequently faced with a wide array of other undesirable physical and mental side effects. These individuals often feel irritable, depressed, or fatigued.

In addition, burnout can greatly affect the quality of health care these physicians are able to provide. Because of their fatigue, they may make unintentional errors. These errors could threaten patients’ health and lead to malpractice suits, further worsening the physician. Their patients may notice that these physicians are not attuned to their needs, which can lead to poor patient satisfaction and a decrease in overall quality of care. In addition, physicians who are overwhelmed are highly likely to look for a different job or even a completely new career path. This may lead to a high turnover rate and periods of being short-staffed further worsening physicians' mental state in that facility.

Symptoms of Physician Burnout

While physician burnout is displayed in a huge variety of symptoms, there are three key symptoms that can be seen in nearly all physicians feeling extremely overwhelmed and stressed. These symptoms were described by Christina Maslach in the 1970s and are the foundation for the Maslach Burnout Inventory.

1. Exhaustion

The first key sign of burnout is extreme exhaustion. This is not just typical tiredness after a stretch of long work hours or after dealing with a few demanding patients. Instead, this exhaustion is the feeling that the physician can hardly go on with his work any longer. In fact, some physicians actually question whether or not they can keep up with their work if their feelings do not change.

2. Emotional Unavailability

As burnout worsens, all of a physician’s emotions may be sapped by the job. He or she may feel little more than irritation and anger about the job and the patients. Cynical or sarcastic comments become common as the physician cuts himself off emotionally from his or her patients. The physician’s other relationships, such as with a spouse or significant other, can suffer from this compassion fatigue.

3. Lowered Work Efficacy

Some physicians, particularly female physicians, will also feel as if their work no longer matters when they are burned out. The sense of meaning that the individual once gained from health care work is no longer there. The physician may also worry about making an enormous medical error if no changes occur.

Other Symptoms

While these three symptoms are among the most common experienced by burned-out physicians, some individuals may experience other symptoms, including:

  • Sense of detachment
  • Depression
  • Inattention
  • Variety of mood disorders

In most cases, symptoms build gradually over a period of months or even years. However, for some physicians, a single traumatic event, such as a particularly bad malpractice suit or a major medical error, can immediately bring these symptoms.

Causes of Physician Burnout

There can be many causes of physician burnout. These can be based on the physician's overall mood and personality as well as extenuating circumstances, including the area of medicine in which the physician practices. Personal characteristics, such as the tendency to be critical of oneself or a focus on perfectionism at work, can hasten burnout. However, the majority of factors relate to the job itself or the way the health care organization is run.

1. The Natural Stress of Clinical Medicine

The nature of the job is a huge determinant of burnout. Physicians are constantly working with the most physically and emotionally needy people, many of whom are in pain or dying. They must also work with family members of patients who may demand answers to unanswerable questions. This job naturally has a great deal of stress even on the best of days because physicians often have very little control over who they see and what will happen.

2. The Specialty Area and Specific Job

The physician specialty practice area has its own set of stressors, which can serve to make burnout that much worse. For example, some physicians must take on-call or overnight hours more often than their colleagues do. Others do not make as much money as their colleagues despite working longer hours. Physicians may see more burnout within each specialty area based on facility politics, problems with colleagues, and stressors in a specific provider group. Although it may be tempting to switch jobs, physicians should be aware that they will most likely find themselves faced with another set of stressors if they do so.

3. Poor Work/Life Balance

Physicians frequently have poor work/life balance because of their long hours, demanding work schedules, and requirements of the job that exceed normal business hours. In addition, other stressors at home, such as relationship or financial problems, can further complicate the situation. In these cases, physicians are left with nowhere to relax and rejuvenate their bodies and minds. Unfortunately, medical students are not taught ways to create a healthy work/life balance while they are in school.

4. Ingrained Traits From Medical School

Medical training can teach new physicians attitudes that can actually lead to increased burnout after graduation. Medical students are frequently trained to think that they must be workaholics who never turn down a challenge, who have unlimited supplies of energy, and who are not ruled by their emotions. While the idea that the patient comes first is an important one, medical students must also learn that they cannot successfully care for the many needs of their patients if they do not first address their own needs in healthy manners.

5. Poor Management in the Health Care Setting

A physician’s direct supervisor can also greatly influence how he deals with stress and how close he is to burnout. The fact that a bad supervisor can quickly distort job satisfaction and increase burnout levels have only recently been studied. However, it is a significant problem for many physicians today as new physician groups form more rapidly than ever before without having enough qualified supervisors.

Conclusion

Clearly, physician burnout is not a new problem, but it is one that still has not been fully addressed. The symptoms associated with physician burnout can lead to physical, emotional, and mental strain on the physician. The potential complications that burnout can place upon the physician, their families, and the patients they serve are incalculable. There is the potential for the physician's personal and professional life to be irreparably ruined.

By acknowledging the main causes of burnout in a physician’s career, taking steps to deal with stressors as they happen, and making time for caring for one’s own needs, burnout can be addressed before it leads to permanent negative consequences.

Read more about how to cure and prevent physician burnout here. F