U.S. physician burnout rates drop yet remain worryingly high, Stanford Medicine-led study finds

First, some good news: In late 2023 and early 2024, significantly fewer U.S. physicians reported symptoms of job burnout than they did a few years earlier.

The not-so-good news: Their burnout rates remain stubbornly high compared with those of other American workers.

“It’s concerning because we know from studies published by our research team at Stanford and elsewhere that objective turnover increases and that physicians are more likely to reduce their clinical work hours when burnout is higher,” said Tait Shanafelt, MD, chief wellness officer at Stanford Medicine. “And it comes at a time when we’re already projected to be facing large workforce shortages in medicine, including problems with access to care.”

Shanafelt is the lead author of a study about physician burnout published April 9 in Mayo Clinical Proceedings.

It’s the latest in a series of studies that have provided a snapshot of physician burnout, depression and work-life integration in the United States every three years since 2011. For comparison, researchers evaluate a sample of other American workers at the same intervals.

The studies are not only vital to understanding trends in physician well-being relative to the U.S. workforce but also to gauging the impact on the health care delivery system: On top of its workforce implications, evidence suggests that physician burnout worsens the quality of patient care, increases the risk of medical errors and decreases patient satisfaction.

The Association of American Medical Colleges predicts the United States will face a deficit of 86,000 physicians by 2036. Mitigating the effects of occupational stress in medicine has become a national priority, with the American Medical Association, National Academy of Medicine and the U.S. surgeon general all undertaking efforts to address its underlying causes.

Shanafelt, a professor of hematology and the Jeanie and Stew Ritchie Professor, initiated the series, the first of which was published in 2011. He and his colleagues also published the findings of an off-cycle survey in 2021 — at the height of the pandemic — showing the highest prevalence of burnout and lowest satisfaction with work-life integration in the series’ history. (That particular study did not compare the burnout rates with those of other American workers.)

Since then, job satisfaction among doctors appears to be improving. In the most recent study, 45.2% of respondents reported at least one symptom of burnout compared with 62.8% in 2021, 38.2% in 2020, 43.9% in 2017, 54.4% in 2014 and 45.5% in 2011.

To conduct the study, surveys were sent to physicians between Oct. 19, 2023, and Feb. 26, 2024. Of 9,5079 doctors invited to participate in the survey, 7,643 responded. The ages and genders of the respondents were roughly proportional to those of physicians nationwide.

The physicians were scored on emotional exhaustion and depersonalization — the sense of being detached from work and unfeeling toward patients, respectively — using scales of the Maslach Burnout Inventory, a scientifically developed measure of burnout. The researchers calculated the percentage of respondents manifesting burnout based on a high score in the in one or the other category, or in both.

Women at greater risk

Of the respondents, 58.6% identified as men and 39.6% identified as women, a gender breakdown that approximately mirrors the profession nationally. Burnout rates differed between sexes, with female physicians at risk by about 27% more than male physicians after adjusting for age, specialty and other factors, the study found. Also, doctors in several specialties, including emergency medicine and general internal medicine, were at heightened risk for burnout. This is particularly concerning, Shanafelt said, given that these specialties are often patients’ first point of contact with a health care system.

The investigators used a probability-based sample of nonphysician workers from the general population to compare with a sample of the physician respondents. After adjusting for age, gender, relationship status and work hours, physicians were 82.3% more likely to be experiencing burnout than U.S. workers in other occupations.  

“Many physicians still love what they do, but they just can’t keep doing it at this pace in the current practice environment, with its administrative burdens and regulatory burdens, and the proliferation of asynchronous messaging with patients through the electronic health record,” Shanafelt said, referring to patients’ online correspondence with a doctor. “So physicians are, in essence, just saying, ‘I can’t keep working this way.’”

Lotte Dyrbye, MD, chief well-being officer at the University of Colorado School of Medicine, is the study’s senior author. Researchers from the Mayo Clinic and American Medical Association also contributed to the study.

The study was funded by the Stanford Medicine WellMD and WellPhD Center, the American Medical Association, and the Mayo Clinic Program on Physician Well-Being.