Physician burnout increased massively during the pandemic. (STAT News)

Released this month and published in Mayo Clinic Proceedings, a peer-reviewed journal, results of a survey show that 63% of physicians in the US reported at least one burnout symptom by the beginning of 2022, which recorded an increase from 44% in 2017 and 46% in 2011 while only 30% were satisfied with their work-life balance, compared with 43% five years earlier.

38% of doctors surveyed during the Covid-19 pandemic in 2020 recorded feeling burnout symptoms, while 46% did not feel any stress with their work-life balance.

Bryan Sexton, the director of Duke University’s Center for Healthcare Safety and Quality, said, “This is the biggest increase of emotional exhaustion that I’ve ever seen, anywhere in the literature,” but he was not involved in the efforts of the survey.

However, Dr. Tait Shanafelt, an oncologist at Stanford University who did partake in the research said, "It’s just so stark how dramatically the scores have increased over the last 12 months." Dr. Shanafelt added that “Covid-19 has been a uniquely traumatic experience for the health workforce and for their families... if we fail to act, we will place our nation’s health at risk.”

As noted by Dr. Shanafelt as well, the research on burnouts during the pandemic was centered on certain specialties and geographic hot spots, rather than the entire profession, but that changed with the new data set.

Higher rates of alcohol abuse and suicidal ideation were among the main factors leading to physician burnout, alongside the rise in medical errors and thus worse patient outcomes. This led the US surgeon general, Dr. Vivek Murthy, to issue an advisory in May as a preventative measure.

Although burnout has become a universal term, the condition has a definition in medical literature as being measured from three angles - emotional exhaustion, depersonalization from work, and a sense of personal accomplishment.

When the metric was first proposed, a widely held belief was that burnout could be blamed on the dispositions of individual physicians. As explained by Dr. Colin West, a physician at the Mayo Clinic and contributor to the survey efforts, he said “that these are just weaklings" but that over the progression of time, the problem persisted and that this belief was no longer valid. “This couldn’t just be pawned off as a handful of people who couldn’t handle the career,” Dr. West said.

The National Academy of Medicine released a 312-page report in 2019 just on detailing the condition of physician burnout, which Dr. Shanafelt helped write, demonstrating evidence suggesting that the dissatisfaction of doctors with their work could be the result of a contradiction between what they cared about and what the healthcare system encouraged them to do.

“We cared about quality of patients’ experience, building relationships with them, and then there were all these things we got paid for,” Dr. Shanafelt said. “Even something that was once a good thing can become tarnished,” he added.

Other health workers also suffer from burnout, as demonstrated in a study published by Dr. Sexton of more than 70 hospitals this month stating that burnout is a phenomenon. “A lot of a person’s exhaustion score is connected to who they work with,” he said. “There’s a social contagion in burnout. If your colleagues are fried and you’re not, give it six months and you’ll look just like them.”

During the pandemic, while emergency and family physicians worked non-stop and were constantly exposed to the virus, their counterparts in other specialties were able to use online tools to communicate with patients and thus spend more time with their families. The rise of remote work might explain why emotional exhaustion rates actually declined among physicians in mid-2020 to the lowest since the survey began in 2011, but mental health rates also saw a staggering decline two years into the pandemic.

Emergency practice physicians were probably the most affected, as Dr. Shanafelt said the shortage of mental health services could be the reason why. “They’ve got 10 minutes to take care of their patients. There’s no psychiatrist or therapist to refer them to because our health care system is overwhelmed," he said. The increase in burnout is most likely a mix of new problems and exacerbated old ones, Dr. Shanafelt said. For instance, the high number of messages doctors received about patients’ electronic health records was closely linked to increased burnout before the pandemic. After the pandemic, the number of messages from patients coming into physicians’ In Baskets, a health care closed messaging system, increased by 157%.

Physicians even placed blame on the politicization of science, labor shortages, and the vilification of health care workers as significant issues, in addition to being bullied, threatened, or harassed by their patients at work in the past year, which 23% of physicians reported in 2021.

Regarding finding a potential way out of this issue, Dr. West stressed the need for data to combat the condition effectively while saying that “all the solutions run through a common pathway."

"They connect people with their most meaningful activities. What that means is it’s less important what the specific tactic is, and more important to make sure that, whatever the solution is, it’s aligned with our basic, fundamental goals. This [survey] really provides a 30,000-foot view pulse check, so that we’re not just guided by our feelings and our intuition,” he said.

Dr. Sexton added, “On a hopeful note, we know that there are simple interventions that can have as much a positive effect on well-being as the pandemic had a negative effect. So, yes, things are worse during the pandemic, but they’re not so bad that we don’t know how to fix it.”