'I cry and no one cares': Medscape survey shows doctor burnout, depression is getting worse

Physician burnout and depression continue to worsen, according to a new report from Medscape. 

The findings are especially concerning at a time of waning COVID-19 and greater awareness of the harmful effects of physician burnout and depression, Leslie Kane, senior director of Medscape Business of Medicine, told Fierce Healthcare. 

“You might think that maybe things are getting a little bit better, but they're definitely not,” Kane said. 

In the survey, more than half of physicians said they are feeling burned out, up from 42% saying so in 2018 and 47% in 2021. Nearly a quarter also reported being depressed in 2022. Most said job burnout was the reason for their depression, with nearly half also saying world events greatly contributed to it.

The report, titled "I Cry and No One Cares," is based on a 2022 Medscape survey that reached more than 9,100 U.S. physicians across 29 specialties. The report is so titled after the confession of a respondent in the survey.

Emergency medicine continues to be the medical specialty with the most burned-out doctors, per the survey, followed by internal medicine and pediatrics. The specialties most affected have shifted; the number of emergency medicine doctors, family physicians and internists experiencing burnout is up compared to five years ago. Women continue to be disproportionately impacted by burnout. Two-thirds of doctors said burnout has negatively impacted their relationships.

This year’s report showed less burnout in solo practices than in other work settings thanks to autonomy and having control over productivity. Some doctors might consider switching their form of practice to help reduce burnout, Kane suggested. 

For most doctors, workplace stress is caused by too many bureaucratic tasks like paperwork, lack of respect from co-workers, long work hours and insufficient compensation. There are some tactical tools that can help, but not solve, the problem, Kane suggested, like using a scribe for note-taking or leaning on artificial intelligence to fill out prior authorization paperwork. 

Most cope with burnout by exercising and talking with family or friends. Nearly a third have reduced work hours. 

What would help most with burnout, doctors reported, is higher compensation, a more manageable work schedule and more support staff. As more physicians become employed by health systems, they work longer hours than they are paid for, the report suggested. Their only option is to ask for a raise “to at least make them feel more respected and valued,” Peter Yellowlees, M.D., chief wellness officer at the University of California, Davis, said in the report. 

Half of doctors said they believed a union would help combat burnout. But, the report cautioned, that could be a last-ditch effort to bring more attention to the issue. Nearly half of respondents said their workplace offers a program to reduce burnout, while more than a third said it does not.

Nearly half of doctors surveyed have not sought professional help to reduce their burnout, though they’d consider it. More than a third have not and would not. More than a third also said they would rather not tell others of their depression. This speaks to the ongoing stigma for physicians seeking mental health support, Kane noted, with more than half of respondents believing depression says something negative about them. Additionally, 4 in 10 believe people will think less of their professional abilities and fear the medical board or their employer will find out. 

Overall, a quarter of doctors are depressed. Of those, two-thirds have colloquial depression, while a quarter are clinically depressed. While half of respondents said their patient interactions are not affected by their depression, nearly a third said they become easily exasperated and nearly a fifth said they are less careful with taking patient notes. 

Having peer groups and mental health support programs available for doctors is really important, Kane noted. Keeping up communication with a provider organization’s leadership is key to help them understand doctors are leaving the profession over burnout, Kane said. “Hospitals don't want that, so they really do have a vested interest in keeping their staff there, in keeping them happy.”

Importantly, Kane encourages doctors to try small changes: “The big thing is to try,” she said. “Whatever you can, little things can make a difference.”