COVID-19 had ‘profound’ effect as physician burnout rose in 2021

Family medicine physicians were among those with the most increased risk of burnout in 2021 as the COVID-19 pandemic took a “profound” toll on the nation’s physician workforce.

The findings were part of “Changes in Burnout and Satisfaction With Work-Life Integration in Physicians Over the First 2 Years of the COVID-19 Pandemic,” a new study published by Mayo Clinic Proceedings. Researchers surveyed 2,440 physicians across 24 specialties from December 2021 to January 2022 and found 62.8% of physicians had at least one manifestation of burnout in 2021, compared to 38.2% in 2020, 43.9% in 2017, 54.4% in 2014, and 45.5% in 2011, the years of previous similar surveys.

“The collective effect on the U.S. physician workforce appears to be profound,” the study said. “Given the association of physician burnout with quality of care, medical errors, reductions in clinical work effort, turnover, departure from practice, and healthcare costs, these findings also have potentially critical implications for the U.S. healthcare delivery system.”

The results are another measure of how COVID-19, the accompanying societal and economic effects of the virus, and other factors, left many physicians exhausted physically, mentally, and emotionally. Just this month, Medical Economics and The Physicians Foundation have published findings of separate surveys that indicate the levels of burnout in the physician workforce.

Results are in

The large increase in distress appeared primarily related to occupational distress, because levels of depression increased by “a more modest 6.1%,” the study said.

Among the key findings:

• 30.3% reported they agreed or strongly agreed that their work schedule left enough time for personal and family life. That was down from 46.1% in 2020, 42.8% in 2017, 40.9% in 2014, and 48.5% in 2011.
• Emotional exhaustion scores were 38.6% higher than the 2020 results.
• Depersonalization scores were 60.7% higher than the 2020 results.

Collective results were striking, but figures for certain subgroups and specialties “are even more alarming,” the study said. The survey confirm previous findings of increased risk for burnout and work-life conflict in women physicians.

Physicians practicing emergency medicine, family medicine, and general pediatrics “were at increased risk for burnout after adjusting for other personal and professional characteristics,” the study said.

Possible solutions

In the last two years, high-level reports and legislation have documented effects of physician burnout and have outlined plans that could help. Those include the National Academy of Medicine report “Taking Action Against Clinician Burnout: A System Approach,” and an accompanying action plan; federal funding to address health care worker burnout; the Dr. Lorna Breen Health Care Provider Protection Act; and the U.S. Surgeon General’s advisory, “Addressing Health Worker Burnout.”

The authors called for health care organizations to adopt an expansive and holistic approach to integrate large-scale changes for health care delivery, not just added resilience training or resources to help workers in distress.

Things got better, then worse?

From 2017 to 2020, there were a number of explanations for improvements in burnout and work-life integration scores. For example, many parts of the country had not yet experienced COVID-19, and the pandemic sparked use of virtual care, decreased documentation, and better team-based care – all potentially positive changes to health care delivery.

“An additional year into the pandemic the results are starkly different,” with physicians drained by staff shortages, attitudes of anti-science and incivility, and new dimensions of moral distress. Outside medicine, physicians, health care workers, and people in general were dealing with school and childcare challenges, social justice unrest, gun violence, the Russian invasion of Ukraine, inflation, and economic concerns, the study said.