Physician burnout in the U.S. is rising, presenting a “potential threat” to the healthcare system’s ability to function properly, researchers asserted Oct. 6 in JAMA Network Open [1].

Prevalence of such workplace fatigue is higher among physicians who are female, work in primary care (compared to other specialties such as radiology), or have 10 years of experience or fewer. The findings were derived from surveys of 1,373 physicians in a large multispecialty group in 2017, 2019 and 2021, charting changing workplace dynamics over a five-year period.

“The findings of this survey study suggest that the physician burnout rate in the U.S. is increasing,” Marcus V. Ortega, MD, an OB/GYN specialist with Mass General, and co-authors concluded. “This pattern represents a potential threat to the ability of the healthcare system to care for patients in the U.S. and needs urgent solutions.”

Researchers conducted the survey among faculty members of the Massachusetts General Physicians Organization. Participants represented a full range of career stages and clinical specialties including internal medicine (54%), primary care (16%) and surgery (12%). The other 18% was a fourth category that lumped together specialists in radiology, emergency medicine, anesthesia and pathology. Questions covered four different domains: career and compensation satisfaction, well-being, administrative workload, and leadership and diversity.

Across all respondents, the burnout rate dropped from 44.4% in 2017 to 41.9% in 2019 before leaping up to 50.4% in 2021. Among the specialty category that included radiology, the number climbed from 40.1% to 43% in 2019 and 47.6% by the final year of the study.

Ortega et al. found that most physicians stayed in the same state of burnout throughout the three survey periods. About 26.7% of physicians experienced burnout, scoring high marks in 2 of 3 subscales across all three surveys. Meanwhile, 35.4% did not reach high burnout scores in any of the intervals. Over 30% of physicians increased their high-score status, while more than 60% didn’t see a change during the study period, the authors reported.

Looking at specific burnout measures, compared with 2019, the 2021 exhaustion score increased by 20% across all physicians. The cynicism score also climbed by 20%, while the “reduced personal efficacy score” increased by 9%. Among female physicians, the exhaustion score was greater by 11% compared to male peers. PCPs also had a 25% higher exhaustion score and 20% higher cynicism score than internal medicine specialists.

Ortega and co-authors speculated that the pandemic may have been one key influencer on these numbers.

“In the U.S., the COVID-19 pandemic has had profound implications for the physician workforce nationwide,” the study noted. “We found increasing burnout during the pandemic. Pandemic-related uncertainties have also taken an emotional and physical toll at the personal level and affected the labor force scarcity.”

Several other personal and professional factors also play a role, the authors added.

“Those with less burnout often had more years of experience, suggesting that familiarity with the profession is associated with reduced stress,” Ortega et al. wrote. “These physicians also spent less time on administrative tasks, pointing to increased job satisfaction with less bureaucracy. Greater satisfaction with compensation among physicians with less burnout implied that financial contentment is associated with a lower exhaustion score. These individuals were also less likely to be PCPs.”

Read more, including potential study limitations, in JAMA at the link below.