A shocking number of US doctors are burned out and overworked

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Doctors are burned out, and the problem seems to be getting worse.

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A national survey of almost 7,000 physicians found that over 54% reported at least one symptom of burnout in 2014, up from 46% in 2011. The results were published online in Mayo Clinic Proceedings December 1.

Only 41% of physicians said they are satisfied with their work-life balance, compared to 49% in 2011.

"Burnout among physicians has effects on quality of care, patient satisfaction, turnover, and patient safety," the authors wrote in the study, calling for research-backed interventions to prevent it.

Those at highest risk for burnout are emergency room doctors, urologists, family medicine doctors, and physicians practicing physical medicine and rehabilitation. Neurosurgeons were by far the least satisfied with their work-life balance.

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This chart from the paper compares how physicians with different specialties reported their work-life balance satisfaction (higher up = more satisfied) and their level of burnout (further to the right = more burned out):

About two in five doctors are depressed, and 6% said in the survey they had thoughts of suicide. Between 300 and 400 doctors commit suicide every year, according to the American Foundation for Suicide Prevention.

Dan Ariely, a behavioral economist at Duke University, and Dr. William L. Lanier, editor in chief of the Mayo Clinic Proceedings Editorial Board, wrote an opinion piece accompanying the study. They argued that doctors' high levels of stress come from three main factors: the administrative burden of the health care system, the need to make difficult decisions under incredible pressure, and the devastating consequences that can result when doctors make a wrong decision.

"Imagine living with the constant fear that any mistake could be very painful and expensive," they wrote in the editorial. "In what ways will such a fear affect your performance?"

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Physicians are almost two times more likely to be burned out than the general population. In a survey of US working adults who weren't doctors, only 29% reported burnout. And 55% said they were happy with their work-life balance.

The consequences of doctor burnout are also potentially much more serious than in other professions. When physicians are burned out, previous studies have found, they are more prone to making errors that could result in patient harm or even death.

Ariely and Lanier call the current healthcare system a "fixing-people production line," and argue that physicians should be able to treat their work more like research and development - medical care has tremendous uncertainty, after all, and doctors should be able to make thoughtful, calculated decisions and then change their approach as necessary to treat patients.

"Unless we are going to recognize that such production line logic is the wrong metaphor for medicine, medical practitioners will experience more stress, fewer people will choose a healing profession, and patients will experience even worse outcomes," they wrote. "It is time to change direction and change the structure of the medical system from a system that focuses on micromanaging physicians' time and decisions to a system that focuses on long-term health."

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