Primary care physicians in 10 developed countries say their burnout is severe and could compromise the quality of care they provide patients, a new survey found. But the findings hold a sliver of good news for clinicians in the United States: Burnout here may not be as bad as it is for their colleagues in many other nations.
The survey, from the Commonwealth Fund, a foundation promoting high-quality, equitable healthcare, is one of the first to compare data from multiple countries and adds to a mountain of evidence that burnout is a serious problem confronting physicians in the United States and abroad. The new analysis included respondents in the US, Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, and the United Kingdom.
As bad as burnout has been in the United States, clinicians in Canada, the UK, and New Zealand consistently reported even worse levels of burnout and emotional distress, the survey showed.
“In so many instances, we find that the US healthcare system is trailing behind other systems. But in this study, we find that all healthcare systems really need to figure out how to prioritize the well-being of the primary care workforce if we hope to have a sustainable, high functioning, high performing healthcare system,” said Reginald Williams II, AB, vice president of international health policy and practice innovations at the Commonwealth Fund, at a press conference announcing the findings.
David Blumenthal, MD, president of the Commonwealth Fund, said the rates of clinician burnout point to a crisis among primary care clinicians that is global in proportions. “If our frontline doctors, both here in the US and around the world, are overstressed and don’t feel like they’re doing their best work, that should raise serious concerns for us all,” Blumenthal said in a statement about the findings.
Blumenthal expressed concern that nearly half of older clinicians who were surveyed said they would stop seeing patients in the next 1 to 3 years, leaving a younger, more burnt-out workforce.
The new survey queried more than 9500 primary care physicians. Final country samples ranged from 321 to 2092 respondents. Clinicians were asked about their workload, levels of stress and burnout, their career plans, and the quality of care they feel they’ve delivered since the start of the COVID-19 pandemic.
Among the findings:
New Zealand had the highest rate of burnout in the survey, with 57% of younger physicians and 40% of older physicians reporting the condition.
New Zealand also had the greatest percentage (74%) of younger physicians reporting emotional distress.
Primary care physicians in the Netherlands fared best, with 23% reporting burnout, the lowest rate in the survey.
More than half of respondents said their workload had increased since the start of the COVID-19 pandemic and that their jobs had become more stressful as a result. According to the survey, 58% of physicians in the United States said their job was stressful, 54% felt emotional distress, and 44% were burnt out. Roughly two thirds (65%) of physicians in the United States said their workload had increased “somewhat” or “a lot” compared to prepandemic levels.
The new survey found that stress and burnout appear to be affecting older and younger physicians unequally.
Around half of all younger primary care physicians in the United States reported burnout, compared to 35% of older primary care physicians. Slightly more than half (53%) of physicians older than 55 reported having stressful jobs, compared to 63% of those younger than 55. And 61% of younger clinicians reported feeling emotional distress in their jobs, compared with 46% of older physicians. However, only 6% of older clinicians and 16% of younger physicians said they had received help for their distress.
In the United States, 28% of the doctors who experienced stress, emotional distress, or burnout said the quality of care they provided to patients had worsened “somewhat” or “a lot” since the pandemic began. Just 8% of physicians who did not feel stress or burnout felt their ability to give quality care had worsened.
A Medscape Physician Burnout Survey from 2022 found that 23% of clinicians who experienced burnout said they were less careful or were less motivated to take good notes on patients because of depression, and 34% said they become easily exasperated with patients.
“Policymakers and health leaders can take steps now to address this growing workforce crisis by investing more into primary care systems, ensuring that doctors are practicing healthy work environments that are not harmful to their physical and mental health,” Blumenthal said in the press conference. “Primary care is the backbone of a high performing health care system. And it is vital to the well-being of communities across America and around the world.”
The study was supported by the Commonwealth Fund. Blumenthal and Williams report no relevant financial relationships.
The Commonwealth Fund. Published November 17, 2022. Full text
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