Physician burnout: Which medical specialties feel the most stress

An online survey of doctors finds an overall physician burnout rate of 42%, which is down from 46% five years ago. Three new entries in the top six specialties with the highest rates of burnout compared with last year’s edition of the survey provide medical students and residents with new insight into their future careers. 

The survey finds finds the physician burnout rate continues to drop and remains below 50% among doctors in the U.S., which mirrors results from a triennial study from the AMA, the Mayo Clinic and Stanford University School of Medicine. However, more work still needs to be done.

More than 15,000 physicians from 29 specialties responded to the survey conducted by the Medscape news website. The survey asked about the prevalence of physician burnout factors and how they affect doctors’ lives. This year, nephrology saw the biggest increase in physician burnout, climbing from 32% to 49%.

In the Medscape survey, the highest percentage of physician burnout occurred among these medical specialties:

• Urology: 54%.
• Neurology: 50%.
• Nephrology: 49%.
• Diabetes and endocrinology: 46%.
• Family medicine: 46%.
• Radiology: 46%.

The lowest rates of burnout were reported by physicians in these medical specialties:

• Public health and preventive medicine: 29%.
• Ophthalmology: 30%.
• Orthopedics: 34%.
• Psychiatry: 35%.
• Otolaryngology: 35%.
• General surgery: 35%.

Physician burnout affects all specialties and practice settings, but beyond medical specialty there are other drivers behind the phenomenon.

1. Work factors that hinder well-being

   1. Are you working too many hours, or taking work home with you? Answering yes to these questions—or several others related to your work environment or demographic profile—increases the odds that you are a physician experiencing symptoms of burnout. 

2. Women physicians more prone to doctor burnout

   1. Burnout is often associated with work-related stressors, but those too can vary in their impact on individual physicians, according to a National Academy of Medicine discussion paper. And while many causes affect both men and women, there are factors at play that more prominently affect female burnout in medicine.

3. Personal factors signaling physician burnout risk

   1. Workplace pressures tend to dominate the discussion on physician burnout, but for many doctors there are substantial risk factors at play even before they pick up their stethoscopes to start another day of practice. Those factors are tied to age and relationships, among other things.

4. How physician burnout is costing your organization

   1. A growing body of research reveals that spending a moderate amount on programs to reduce physician burnout appears to be an investment that is worth it in the long run. 

According to the Medscape survey, the top causes of burnout have not changed over the years, with 55% of respondents choosing “too many bureaucratic tasks” as the leading cause of burnout.

One-third said spending too many hours at work added to their stress, while 32% said lack of respect from administrators, colleagues or staff contributed to burnout. 

1. Cut documentation burdens that lead to doctor burnout

   1. Many of these burdens come from external requirements. A major overhaul in evaluation and management (E/M) office visit codes—the first in more than 25 years—has the potential to significantly reduce documentation burden and provide physicians with more time with patients.
   2. The AMA worked with the Centers for Medicare & Medicaid Services and convened a coalition of 170 state and specialty medical societies to simplify the requirements and make them clinically relevant.
   3. The AMA offers tools and resources to help practices transition to the new reporting guidelines that take effect Jan. 1, 2021. That includes a checklist to help guide your practice through the E/M changes. 

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2. Make changes to inefficient clinical workflow

   1. The AMA has unveiled six clinical workflow modules on topics such as “getting rid of the stupid stuff” and medication management that can help you implement more meaningful changes in your practice and reclaim up to three hours every day.

3. Have your organization take this pledge on physician burnout

   1. While challenges of doctor burnout remain widespread, addressing well-being can benefit patients, physicians and the health care system. One way for health systems, organizations and individual physicians to tackle the problem is to endorse the Charter on Physician Well-Being and implement its recommendations. 

4. Implement these interventions for doctor burnout relief

   1. There has been growing interest in physician burnout, with health care organizations launching their own solutions to improve well-being. But how have those different interventions affected physician burnout? Research is uncovering the effect of organization-directed workplace interventions on physician burnout.

5. Tame the in-basket with teamwork

   1. The default destination for most communication in the physician office is a doctor’s in-basket, housing overwhelming numbers of items and folders. As the workload grows, so does the volume of the in-basket, creating a burden that is difficult to effectively manage throughout the day. Learn how to wrangle your inbox.

6. Close the physician burnout solutions research gap

   1. Learn how the multiyear, multimillion-dollar AMA Practice Transformation Initiative is addressing the large gap in research on actionable solutions to mitigate doctor burnout.

Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing, issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand and reduce the challenges physicians face. By focusing on factors causing burnout at the system-level, the AMA assesses an organization’s well-being and offers guidance and targeted solutions to support physician well-being and satisfaction. 

Meanwhile, the AMA STEPS Forward™️ open-access modules offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These courses can help you prevent physician burnout, create the organizational foundation for joy in medicine and improve practice efficiency.

STEPS Forward is part of the AMA Ed Hub™, an online platform that brings together all the high-quality CME, maintenance of certification, and educational content you need—in one place—with activities relevant to you, automated credit tracking and reporting for some states and specialty boards.