Physician burnout is a serious problem, and it doesn't just build over decades in the profession. In fact, it often starts in medical school and residency, according to a new JAMA study.
The prospective cohort study found wide differences in burnout and career choice regret depending on clinical specialty.
A second JAMA study found substantial differences in physician burnout estimates and how they were measured, which makes proving consistency across disparate studies difficult.
The two reports add to a growing list of research on the topic. The 2018 Medscape Physician Lifestyle Report said nearly two-thirds of U.S. doctors experience feelings of burnout, depression or both. Physician burnout can cause medical errors. The Agency for Healthcare Research and Quality said burnout can lead to negative quality of care and poorer patient outcomes.
In recent months, burnout studies found physician wellness and quality of care are connected, doctor burnout is less common in small, independent practices and organizational flaws compound burnout problems. Burnout is also costing health systems and hospitals as much as $1.7 billion a year.
One of the new JAMA studies looked at 3,588 second-year resident physicians and found burnout occurred in 45.2% of those surveyed. Nearly 15% regretted their career choice.
Higher rates of burnout were found in doctors training in urology, neurology, emergency medicine and general surgery. Female doctors reported symptoms of burnout more than men. Anxiety levels were reported higher during medical school for the new doctors.
Feelings of career regret were more common in those training in pathology and anesthesiology. However, those specialty areas had a low percentage of burnout symptoms. The researchers suggested career choice regret may come from factors other than burnout.
Meanwhile, the second study's researchers looked at 182 papers on the topic published between 1991 and 2018, including more than 100,000 people in 45 countries. Overall burnout prevalence ranged from zero to 80.5% depending on the study. Also, emotional exhaustion, depersonalization and feeling low personal accomplishment ranged by similar percentages.
The researchers were unable to find connections between burnout and factors like gender, age, geography and specialty "because of inconsistencies in definitions," according to the report.
"This review indicates that a more consistent definition of burnout and improved assessment tools may be necessary if these policy measures are to successfully improve the physician work environment," the authors wrote.
The researchers also provided suggestions for future research on the topic, including using agreed upon diagnosis criteria for clinical burnout, considering new tools to gauge burnout and strictly adhering to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.