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Physician Burnout and Suicidality a Major US Health Care Issue

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According to the American Medical Association, physicians have an elevated risk of burnout, suicidal ideation, and suicide compared with the general population. Suicide is one of the most prevalent causes of physician mortality, and rates are about double that of the general public. Women physicians are particularly at risk and are between two to six times more likely to commit suicide than women in general.

This contrasts with lower rates of illness among physicians than the general population in areas such as tobacco-related cancer, heart disease, and stroke. Among the contributing factors to this disparity are often hectic and rushed healthcare environments in which time pressure is omnipresent and emotional intensity is a factor.

With some studies placing burnout among US physicians at above 50 percent, this affects not only the quality of treatment provided but also the continuity of care, as burned-out doctors are more liable to quit their practices. In addition, they suffer from impaired executive function and memory and attention deficit. The cost to the US healthcare system is substantial, with the overall cost estimated at $4.6 billion, or $7,600 per physician.

A paper published in Frontiers of Public Health in 2023 addressed the relationship between physician burnout and anxiety, depression, substance abuse, and suicidality. Some 61 articles were systematically reviewed, with the measurement and criteria employed in defining burnout described as “heterogeneous.” This made the assimilation of results a challenge. However, studies were consistent in reporting a clear association between burnout, depression, and anxiety. The link between substance abuse and burnout was less clear, as was that between burnout and suicidality, which is more challenging to measure.

Among the common contributing factors identified for psychological morbidity were chronic workplace stress and insufficient space and time to attain a work-life balance. In addition, a“culture of invulnerability” was reported among physicians that led to symptom denial and self-diagnosis and treatment. Stigma among medical peers and worries about career prospects also hindered seeking help.

Beyond the study, troubling demographic trends are on the horizon. According to a 2023 National Council of State Boards of Nursing survey, half of the nurses, four million of the nation’s largest medical workforce, are considering leaving their jobs. Some 800,000 nurses already have plans to do this by 2027. At the same time, 96 percent of medical professionals agree that burnout is a significant issue.

Among the systemic elements that could be improved in countering burnout and suicidality is scaling back unreasonable work demands and placing patient and provider welfare before profits. Unfortunately, physicians face the overhanging threat of malpractice suits, even though flawed electronic health records are a much more common cause of patient harm. As a result of an overly complex and often litigious healthcare system, it’s not uncommon for physicians to spend 65 percent of their workday undertaking data entry instead of caring for patients.

The silver lining of this situation is that healthcare providers and the general public are increasingly aware of burnout as a serious issue. Led by organizations such as the Clinician Burnout Foundation, steps are being taken to set up support groups and ensure that physicians can seek peer-informed remedies when their workload or job-related stress grows too overwhelming.