Physicians experience a higher rate of burnout than the general population—37.9 percent versus 27.8 percent, according to a recent study in Archives of Internal Medicine—and emergency physicians report more burnout than all other medical specialties.1 Physicians also have higher suicide rates than the general population—70 percent higher for men and 250 to 400 percent higher for women—even though rates of depression are about the same for physicians and nonphysicians.2 Suicide is the most common cause of death among medical residents.3 Despite this increased risk, one study found that only 26 percent of surveyed physicians who had suicidal ideation sought help.3
Explore This IssueACEP Now: Vol 35 – No 01 – January 2016
The effects of health care modernization also play a role in burnout: computerization was ranked 3.68, and the Affordable Care Act’s impact was 3.65.
Causes of Burnout
According to Medscape’s 2015 Physician Lifestyle Report, bureaucratic tasks are the top cause of burnout, at 4.75 on a scale of 1 to 7.4 Long work hours and insufficient compensation came next at 3.99 and 3.71, respectively. The effects of health care modernization also play a role in burnout: computerization was ranked 3.68, and the Affordable Care Act’s impact was 3.65. Patient concerns also contribute to burnout, with difficult patients at 3.37 and too many patients at 3.34. Lack of professional fulfillment was lower on the list, ranked at 3.05.
What Can You Do to Combat Burnout and Suicide?
A 2015 Cochrane Review found that cognitive-behavioral training, mental relaxation, and physical relaxation can all reduce workplace stress moderately.5 With the exception of being able to control work schedules, workplace interventions (improving support, mentoring, communication skills training, etc.) didn’t have a noticeable effect on employees’ stress levels.
Recognizing the warning signs for suicide is an important first step to preventing it. The American Association of Suicidology offers this mnemonic for the warning signs of suicide:
Is Path Warm?
ACEP President Jay A. Kaplan, MD, FACEP, weighs in on the burden of depression for emergency physicians here.
- Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172:1377-1385.
- Hampton T. Experts address risk of physician suicide. JAMA. 2005;294:1189-1191.
- Andrew LB. Physician suicide. Medscape website. Accessed Dec. 11, 2015.
- Peckham C. Burnout and happiness in physicians: 2013 vs 2015. Medscape Family Medicine. Jan. 26, 2015.
- Ruotsalainen JH, Verbeek JH, Mariné A, et al. Preventing occupational stress in healthcare workers. Cochrane Database Syst Rev. 2015;4:CD002892.