News Blog reader Alastair Sterling drew my attention to a report on doctor burnout across OECD countries.[1] Burnout rates were high everywhere, but not particularly so in the UK. It was hard to make comparisons, because the survey was based on respondents who might have differed from place to place. Some studies have indeed compared different members of the workforce with respect to burnout rates. A number of studies have shown that physicians have higher burnout rates (along with other sorts of psychological morbidity) than other groups. A recent perspective on this subject in the Lancet referred to a 2012 study saying, “the risk of burnout decreased with each additional higher level of education… the only outlier was a degree in medicine that instead increased burnout risk by 36%.”[2][3]

Of course, this does not clarify whether the problem lies with the particular demands of medical practice or a lack of resilience among people who choose to go into medicine. While there is no irrefutable evidence on this point, people going into medicine do not have higher levels of vulnerable psychologies than their peers. If anything, the evidence points the other way and people who are accepted into medical school tend to have better baseline quality of life than other students.

Medical practice does produce some particular and unrelenting forms of stress. Encounters with clients are intense, and the responsibility unrelenting. Stress is an ineluctable part of medical practice. Doctors have to deal with extensive bureaucratic pressures and the demands of inflexible information systems. While all professions have to deal with IT, the contribution of IT to burnout among both US and British doctors has been featured in a previous News Blog [4] and in Bob Wachter’s brilliant book on the digital doctor.[5]

It seems that the problem of burnout among doctors is very real. Some of its causes are difficult to eliminate – the psychological pressure of dealing with sick people and their worried families can never go away. However, better management and organisation, and a more realistic set of expectations, might go some way to preserving the health of the people who look after other people’s health.

Richard Lilford, ARC WM Director

References:

1. Medscape. Global Physicians’ Burnout and Lifestyle Comparisons. 2019.
2. Marchalik D. Physician Burnout in the Modern Era. Lancet. 2019; 393: 868-9.
3. Shanafelt TD, Boone S, Tan L, et al. Burnout and Satisfaction With WorkLife Balance Among US Physicians Relative to the General US Population. Arch Intern Med. 2012; 172(18):1377-85.
4. Lilford RJ. How Many Doctors Do We Really Need? NIHR CLAHRC West Midlands News Blog. 29 January 2016.
5. Wachter R. The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age. New York, NY: McGraw-Hill Education. 2015.