Blog | Thursday, December 22, 2011

QD: News Every Day--Nearly 9 in 10 doctors stressed on any given day


The vast majority of U.S. physicians are moderately to severely stressed or burned out on an average day, with moderate to dramatic increases in the past three years, according to a survey.

Almost 87% of all respondents reported being moderately to severely stressed and/or burned out on an average day using a 10-point Likert scale, and 37.7% specifying severe stress and/or burnout.

Almost 63% of respondents said they were more stressed and/or burned out than three years ago, using a 5-point Likert scale, compared with just 37.1% who reported feeling the same level of stress. The largest number of respondents (34.3%) identified themselves as "much more stressed" than they were three years ago.

The survey of physicians conducted by Physician Wellness Services, a company specializing in employee assistance and intervention services, and Cejka Search, a recruitment firm, was conducted across the U.S., and across all specialties, in September 2011. Respondents mirrored the AMA 2009 Physician Masterfile, with 2,069 completed surveys representing a 99% confidence level with a +/- 3% margin of error compared to about 750,000 physicians. The survey respondent sample skewed more toward non-primary care practices by 11.1 percentage points, possibly reflecting a younger survey sample and fewer primary care medical school graduates.

The top four external stress factors are the economy (51.6%), health care reform (46.4%), Medicare and Medicaid policies (41.2%), and unemployed and uninsured patients (29.7%). Only 8.6% of respondents reported no external stressors.

The top four work-related stress factors are administrative demands (39.8%), long work hours (33.3%), on-call schedules (26.2%), followed by medical malpractice lawsuits, insurance company interference, conflict or disagreements with administrators, increased complexity of care and electronic health/medical records. Only 1.1% reported no stress from work.

The top three personal life-related factors were not enough leisure time (52.6%), not enough time for exercise or wellness (50.6%), concerns about work/life balance, in general (45.0%), followed by concern about finances or sleep. Only 8.4% of respondents indicated that there was nothing stressing about their personal lives.

The result of the stress is declining job satisfaction (51.2%), a desire to reduce hours (41.2%) and a desire to retire early (29.9%), nearly tied with a desire to leave the practice of medicine entirely for another career (27.6%). The next two were also related to changes in their work situation: desire to switch jobs (21.8%) and desire to switch to a new practice (15.9%). Only 6.9% of survey respondents reported no work-related stress.

Fourteen percent of respondents indicated they had left their practice as a result of stress, among whom 56.7% continued practicing, but in a different setting, 33.3% continued working in medicine, but in a different job or role, and 10 left medicine entirely. Most noted some improvement, with 42.6% each saying leaving improved their stress and burnout.

Not surprisingly, all the stress triggered tiredness (41.4%), sleep problems (36.7%) and general grouchiness (33.9%), personal health problems (24.7%) and conflicts with a spouse or partner (22.6%). But 9.1% of respondents reported no impact on their personal lives due to stress and/or burnout.

Most doctors handle the stress through exercise (62.8%) or time with family and friends (56.9%). The next cluster involved vacation (47.8%), movies or music (44.3%), reading (38%) and getting more sleep (35.8%). Mentoring, yoga, meditation or peer support were not as prevalent, and doctors commented that finding the time and, in some cases, money to do something was, well, stressful.

Nearly one-third of respondents indicated that better work hours/less on-call time and better work/life balance would help to reduce their stress. Nearly two-thirds of respondents said ancillary support would help. This feedback and the growing trend of part-time work schedules for physicians indicate a need for advanced providers such as nurse practitioners and physician assistants who can provide accessible and effective care as physicians scale back their hours in order to pursue better work/life balance, the companies said in a press release.

[Editor's Note: QD--News Every Day will resume publishing on Jan. 3, 2012]