Burnout among American physicians is at an all-time high, according to a national study published in September by the Mayo Clinic. America's doctors are struggling to thrive in a broken health care system that has become more and more defined by red tape and bureaucracy. Outsized administrative burdens are imposed by both government and private insurance companies alike while patient care takes a back seat. Both physicians and patients are harmed by this status quo as burnout leads to lower qualities of care.
Though sometimes dismissed as an internet buzzword, burnout is an established, well-studied psychological phenomenon with serious mental health impacts. In the 1980s, social psychologist Christina Maslach developed a framework for identifying and measuring occupational burnout that is still in use today. Maslach's framework identifies three main symptoms: emotional exhaustion, depersonalization (colloquially called cynicism or disengagement), and low sense of personal accomplishment.
The Mayo Clinic researchers found that 62.8 percent of American physicians are experiencing at least one symptom of burnout, up from just 38.2 percent in 2020 during the height of the COVID-19 pandemic. Measured emotional exhaustion scores are up 38.6 percent from 2020 to 2021 and mean depersonalization scores increased a staggering 60.7 percent in that same period.
What does this data mean in real world terms? Across the country, doctors are physically exhausted, emotionally drained, and discouraged. They are at elevated risk for mental health conditions and substance use disorders. Some doctors who entered the field to heal sick community members and save lives no longer believe their work matters. They do not feel like they can make a difference and are leaving the health care field early. Only about half of surveyed physicians indicated they would choose to become a doctor if they could do it all over again.
Occupational burnout on this scale damages the entire American health care system. When doctors are unwell, patients cannot get the best quality care. According to a 2018 meta-analysis of 47 studies involving 42,473 physicians, occupational burnout is associated with an increased risk of patient safety incidents, poorer quality of care due to reduced professionalism, and reduced patient satisfaction. Access to quality care is dependent on the well-being of the health care workforce.
Under the status quo, doctors are working too many hours in high-stress environments that lack necessary supports. Hospitals are understaffed and at overcapacity. The health care system is bloated, expensive, and overregulated. Too many entities—from private insurance companies to government regulators—have placed themselves between the patient and the doctor. Physicians are spending more time on the phone with payers and insurance companies than they are with patients.
As a fellowship-trained addiction psychiatrist who runs a multi-state psychiatric urgent care network, I know firsthand how the health care system can wear down physicians trying to provide the best possible care for their patients. I have personally spent thousands of hours on the phone with health insurance companies trying to renegotiate rates for basic services like psychiatric evaluations. Sometimes just a few more dollars per service could make a life-changing difference in the kinds of care we can afford to provide each patient. Yet, insurance companies, regulations, and red tape make providing this care impossible.
These are big, systemic problems that demand bold, creative solutions. Leaders in the field have long been sounding the alarm on this growing crisis, but too often proposed solutions for occupational burnout have focused on individual resilience. Hospitals host trainings on identifying burnout warning signs or practicing self-care. But widespread, systems-level issues do not have individual solutions. Doctors are not the source of this problem, so trying to "fix" doctors will not solve it. The health care system itself needs to change to allow doctors to do their jobs without sacrificing their mental and physical health.
Though the scale is daunting, the problem of occupational burnout in medicine can be fixed. The American Medical Association recently released a recovery plan for America's Physicians, which contains ideas both big and small for tackling this crisis head on, from reforming medical licensing processes to funding research on how systems drive occupational burnout.
Though we can debate solutions, we must all realize that the scale of this problem demands immediate action. Just this year the U.S. surgeon general issued an advisory on physician burnout, calling the need to fight this epidemic a "moral obligation." The National Academy of Medicine stated that the magnitude of the burnout problem "should compel health care leaders to make an immediate and widespread commitment to major systemic changes."
Researchers, major medical associations, and physicians themselves all agree. America's physicians are not okay, and we need to act swiftly and decisively to address this crisis.
Dr. Tamir Aldad is a fellowship trained addiction psychiatrist and the founder and CEO of Mindful Care—the award winning first-ever psychiatric urgent care in the United States. Dr. Aldad graduated with an MBA from University of Chicago Booth School of Business, and completed residency and fellowship training at Northwell Health, after graduating medical school. He also conducted several years of behavioral health research as a physician scientist at Yale School of Medicine. He is passionate about acute mental health issues, public mental health and improving access to affordable care.