Therapy for Physician Burnout: Specialty
According to the 2023 Medscape Physician Burnout and Depression Report, the top five most burned-out specialties are emergency med (65%), internal med (60%), peds (59%), OB/GYN (58%), and infectious diseases (58%). Family med is just outside the top 5 with 57%. The least burned-out specialties are public health and preventative med (37%), Pathology (39%), Cardiology (43%), Nephrology (44%), and Ortho (45%). Women have higher rates of burnout than men. Over 67% of respondents said they have been burned out for 13 months or more.Overall, I am not surprised at the data.
Specialty matters in the world of burnout. Who wants to work their butt off for years to get into a specialty where you have the highest rates of burnout? Who wants to work their butt off and sacrifice for years to have a life that is ruled by work? I looked at the 2023 numbers for unfilled EM slots and it was 500+. Look, the pandemic, poor staffing, and poor leadership that seems to not care about quality of life didn’t help. Taking a look at the bigger picture, you have to think about how an individual is going to be lining up with the organizations that they are working for. How do your specialty's values line up with yours?
I talk about the misaligned values in this blog here. Christina Maslach identified six areas where there are mismatched values between an organization and an individual. These areas are workload, control, reward, community, fairness, and values. Let’s break this down using EM as an example.
Physician Burnout and Workload
What are your organization's expectations for your workload? Is it 1.5? 2? 3? How does acuity factor into this equation? We know that acuity matters but does admin? Are you willing to race through patients just to hit those numbers? Also, do you have to make your own phone calls? Do you have to chase down people for a consultation? How does your team work and function? Is this the night shift or the day shift? Is this specific workload good for your mental health? Is this more than you can chew? Take a step back and recognize what your workload is, how achievable it is, and if it is in your wheelhouse. The workload you take on plays a significant role in burnout. Is this how you want to practice?
Physician Burnout and Control
Are you like many of the other high achievers who have to have control of everything? Well, that may be a determinant to you. Control relates to the care that you are providing. The lack of control can stem from being told exactly what to do, how to do it, and when to do it. Does this sound like trying to game the system with value-based care? Or maybe patient satisfaction scores? Do you actually have input on how you do your actual job? Do you have a voice in how you do your job? Or do you feel like you are just a person who has to follow the algorithm to hit your numbers? Yes Sir. Yes Ma’am. How high should I jump? How much control do you feel like you have with your job?
Physician Burnout and Reward
Alright. Go bust out your MGMA data for your region. Go check out the ACEP compensation report. Where are you? Are you at the top, bottom, or middle of the scale? Are you a high performer and believe you deserve more compensation? What do your benefits look like? Now, it’s not only compensation that you need to look at. How does your medical group reward you? Do you as a professional need kudos? Do you need someone to tell you that you are doing a great job? I’m not saying that it’s necessary but it sure is helpful to know that you are doing a great job and that they actually value you. Being rewarded can come in many different forms. How does a pizza party sound? I’m just kidding. Understand how you feel valued and rewarded. Also, don’t tell me that being a physician is a reward in itself. Yes, it’s true but you should be compensated and rewarded in a manner that you feel is acceptable.
Physician Burnout and Community
Who you work with regularly has a huge impact on your burnout. Are you working with a nurse who hates you? Or are you working with a nurse who is the team player? Also, are you the jerk that barks orders and doesn’t include anyone on the plan of care? Understand that what you give out is what you will get back. What does your community within the pit look like? Are you taking the time to include the nurse in your plan of care? Are you hyping up the team to the patients? As I said earlier, this plays a huge role in the impact of burnout. The ED is a whirlwind but if you are in it together with your team, things are significantly better. No one wants to work with someone who is a grumpy asshole that bites your head off. What does your community look like at work? Does your community build you up to be able to perform at the best of your abilities or does it tear you down?
Physician Burnout and Fairness
Are you and your co-workers treated differently? Is your work different from one another? Are you or your coworker a cherry-picker? Does the admin look the other way when someone does something but when you do it, do they jump down your throat? Unfortunately, work is never going to be perfectly fair. People are treated differently. How much differently is another story. If you notice that someone gets preferential treatment, how do you address this? Is this a battle that you want to take on? Is it worth the time and energy? How much of a difference in treatment is occurring and how does that affect you? Can you live with this difference? Is your workplace fair?
Physician Burnout and Values
The last area to cover is how your values align with the organization that you work for. I’m hearing grumblings about CMGs that are doing business with the almighty dollar as the top priority. How does this align with your values as a medical provider? Again, the question that keeps on coming up is if this is the way that you want to practice medicine. There are always alternatives out there. Maybe you are part of a democratic group. Every single organization has its own problems. It’s more a matter of which organization aligns best with your values. Or maybe it’s time to start your own group. I want you to make sure that you recognize where your values lie and what that shows up in your work. The bigger the misalignment is, the more likely you are going to have issues with burnout.
We just used ED as an example here. Think about your specific specialty. How do you rate in each of these areas? How much of an alignment, or misalignment, do you have? There will rarely be 100% alignment or 100% misalignment. I want you to be able to recognize and make decisions based on where you are at in your life and what your specific needs are. It might be time for a change. Get an understanding of what is going on in your life and your work before you suffer from burnout.
Reach out for Therapy for Physician Burnout
When you’re ready, reach out. Start your journey to overcome physician burnout with Chris Rabanera. Get started with a free 20-minute consultation. Offering online therapy in California, online therapy in Michigan, online therapy in Nebraska, and online therapy in Las Vegas, I specialize in addressing physician burnout, grief counseling, anxiety, depression, and providing tailored mental health treatment for men. Let’s get to work to make lasting positive change.
