More than half of U.S. physicians are burned out—but certain specialties are suffering more than others, according to Medscape's 2017 Lifestyle survey.

Medscape surveyed more than 14,000 doctors from over 30 specialties, who were asked about a range of topics, including burnout and bias against patients. The survey also collected demographic data such as gender, race, and ethnicity.

The state of burnout

The survey defined burnout as having feelings of cynicism, a low sense of personal accomplishment, and a loss of enthusiasm for work.

The survey found that the overall rate of physician burnout in 2017 was 51 percent, significantly higher than 2013's rate of 40 percent. More female physicians (55 percent) than male physicians (45 percent) said they were burned out, but the survey found that burnout appears to be leveling off in both women and men. The burnout rate varied by specialty, with the highest rates of burnout reported among physicians practicing:

• Emergency medicine (59 percent);
• Obstetrics and gynecology (56 percent); and
• Family medicine, internal medicine, and infectious disease specialties (tied with 55 percent).

Meanwhile, the lowest rates of burnout were reported among physicians practicing:

• Diabetes and endocrinology (46 percent);
• Pathology, ophthalmology, and allergy and immunology (tied with 43 percent); and
• Psychiatry and mental health (42 percent).

Different specialties also reported different levels of burnout severity. For instance, although infectious disease specialists ranked in the top five for overall rates of burnout, they reported the lowest severity of burnout on a seven-point scale (3.9). The specialties that reported the most severe burnout were:

• Urology (4.6);
• Otolaryngology (4.5); and
• Oncology (4.5).

When physicians were asked to rate individual causes of burnout on a seven-point scale that ranged from "does not contribute at all" to "significantly contributes," doctors said the leading causes of burnout were:

• Too many bureaucratic tasks (5.3);
• Spending too many hours at work (4.7); and
• Feeling like just a cog in a wheel (4.6).

Happiness at work

The survey also asked providers about their happiness at work. The survey found that the highest rates of physicians reporting being "happy" or "very happy" at work were seen among:

• Dermatologists (43 percent);
• Ophthalmologists (42 percent); and
• Allergy and immunology specialists (41 percent).

The lowest rates were seen among:

• Emergency medicine specialists (28 percent);
• Nephrologists (24 percent); and
• Rheumatologists (24 percent).

Physician bias

The Medscape survey also asked physicians about bias toward patients. Overall, 50 percent of doctors said they had biases toward patients, both positive and negative. Male physicians were more likely to admit holding biases (51 percent) than female physicians (42 percent).

Men and women also differed on which patient characteristics were likely to trigger biases. For instance, 51 percent of male physicians said a patient with a heavier weight could elicit bias, compared with 42 percent of women. And 21 percent of male doctors said a lack of insurance coverage could elicit bias, compared with 15 percent of female doctors. 

Why obese patients often receive worse care

However, Medscape notes that the survey can't account for implicit bias, which occurs at an unconscious level, or a reluctance among certain groups to admit they hold biases. The survey also found that although 50 percent of doctors said they held biases, just 16 percent of those doctors said their biases would have a positive or negative impact on patient care.

Among physicians who admitted bias affected their treatment, the patient factors that were most likely to provoke a negative bias—such as less time spent with a patient or a less friendly manner—were:

• Language differences (61 percent);
• Emotional problems (58 percent); and
• Heavier weight (50 percent).

Meanwhile, the patient factors that were most likely to provoke a positive bias—such as more time spent with a patient or a friendlier manner—among such physicians were:

• Older age (50 percent);
• Low intelligence (32 percent); and
• Race different from self (25 percent) (Thielking, "Morning Rounds," STAT News, 1/11; Peckham, Medscape, 1/11; Rappleye, Becker's Hospital Review, 1/12).

Burnout and the changing physician workforce

Concerns about physician burnout have made national headlines, and the stresses facing health care providers continue to grow. Vendors that want to work with physicians need to understand this new clinical environment before they can succeed.

Check out the infographic to get a breakdown of the changes that are impacting the physician workforce. You'll also learn four new rules of engagement to help suppliers and service firms realign their offerings with the realities of health care providers.