Half of doctors would take a pay cut for less hours, more work-life balance

Female nurse looking stressed
Some 33% of doctors said spending too many hours at work is a reason for burnout, second only to too many bureaucratic tasks. (Getty/gpointstudio)

Half of physicians said they would take a salary reduction of up to $20,000 per year in exchange for working less hours and achieving a better work-life balance, according to a new survey.

The Medscape survey of more than 15,000 physicians found that was pretty consistent across generations. Millennials (52%), Generation Xers (48%) and baby boomers (49%) all said they would take a salary cut in exchange for more personal time. That was true even among millennials, who typically earn less than their more established peers. Some 53% of women said they would take a pay cut, versus 47% of men.

Boomers would give up more money than younger doctors, with 12% willing to take a cut of $50,001 to $75,000 and 6% willing to reduce their pay by more than $75,000 to work 20% fewer hours. That may be because they are earning more, so the drop is less meaningful, or that they are preparing for a retirement lifestyle, the survey speculated.

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The survey found that while overall burnout rates have declined slightly, the problem is worse among mid-career doctors than among younger or older physicians. This year’s survey that focused on the problems of physician burnout and suicide looked at issues based on generational differences. While burnout was down, doctors in Gen X (ages 40-54) experienced a higher rate of burnout than millennials (ages 25-39) or baby boomers (ages 55-73).

The survey found burnout rates have dropped slightly, from 46% in 2015 to 42% this year, but the problem continues to have an impact on physicians’ happiness, personal relationships and career satisfaction, the report said.

RELATED: For first time, burnout rate among physicians drops in new survey, now below 45%

The burnout rate was 48% for Gen X, compared to 38% for millennials and 39% for boomers. Doctors in the middle of their careers may be juggling multiple issues outside of work, Carol Bernstein, M.D., vice chair for faculty development and well-being at Montefiore Medical Center, told Medscape.

Those rates are far less than those reported in a survey last summer that found 79% of primary care physicians experienced symptoms of burnout, with a 68% rate among all the physicians surveyed.

How do doctors cope? Millennials said they are most likely to deal with their symptoms of burnout with sleep, while Gen Xers turn to exercise and boomers said they tend to isolate themselves from others.

Burnout can also lead to depression. Gen X physicians (18%) reported slightly higher rates of depression than millennials (15%) or boomers (16%). Some 23% of men and 22% of women said they have had thoughts of suicide but have not attempted to take their own lives. However, about 1% of physicians have attempted suicide, as an estimated 300 to 400 physicians commit suicide each year.

Nearly 40% of all physicians who report depression say it leads them to be easily exasperated with patients, and 16% in all age groups said depression results in them making errors they would otherwise not make. 

“Our 2020 report shows that while dropping slightly over time, the levels of burnout, and related depression and suicidal thoughts among all physicians remains a concern,” said Leslie Kane, senior director of Medscape Business of Medicine. 

RELATED: Burnout, time spent on EHRs top challenges for independent practice leaders

“However, this year’s report finds that there are generational differences in the rates, severity and factors contributing to the problem. Perhaps these findings can help inform the development of programs that speak to generational and gender differences with respect to burnout, so that we can help drive meaningful change,” she said.

Other survey results included:

  • Women (48%) report more burnout than men (37%).
     
  • The top reasons doctors cited for burnout were too many bureaucratic tasks, such as charting and paperwork (55%)—which was the top reason across all three generations—and spending too many hours at work (33%).
     
  • The electronic health record (EHR), which physicians often site as a reason for dissatisfaction and burnout, is a bigger problem for boomers than younger doctors. Only baby boomers said the increasing computerization of practice with EHRs was in the top three reasons for burnout, cited by 41%. For millennials, who grew up with computers, there’s far less stress, as they said EHR use was near the bottom of the list of 10 potential factors contributing to burnout.
  • Burnout rates differed among specialties. It was highest among urologists (54%), neurologists (50%) and nephrologists (49%). Lowest levels of burnout were reported by orthopedists (34%), ophthalmologists (30%) and public health and preventative medicine specialists (29%). 

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