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AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.
What are top stressors for doctors? How common is physician burnout? What are the most stressful medical specialties? Is administrative burden in health care fixable?
Christine Sinsky, MD, a general internist and AMA’s vice president of professional satisfaction, joins today to discuss the root causes of physician burnout and what the AMA is doing to help doctors feel valued. AMA Chief Experience Officer Todd Unger hosts.
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Unger: Hello and welcome to the AMA Update video and podcast. Today, we’re talking about key takeaways from the AMA’s latest report on physician burnout. We’ll discuss how physicians are feeling overall and which specialties are the most burnt out. Our guest today is Dr. Christine Sinsky, vice president of professional satisfaction at the AMA, in Madison, Wisconsin. And I’m Todd Unger, AMA’s chief experience officer in Chicago. Dr. Sinsky, welcome back.
Dr. Sinsky: Thanks so much, Todd. Always great to be with you.
Unger: Well, the AMA does this exclusive survey every year, and this year, we’ve hit somewhat of a milestone in the fight against burnout. Why don’t we just start by having you tell us a little bit about what that milestone is.
Dr. Sinsky: Of course. Well, while it’s too soon to declare victory, I think there are some really promising signals in the data that we’ve collected over the last four years. We’ve been surveying physicians through their health systems for the last four years, and we have surveyed between five and now 12,000 physicians every year.
And what we’ve seen is that burnout rates have fallen from 56% in 2021 to 53% in 2022, and now in 2023, they’re 48%. And sneak preview, of those that we’ve looked at in the first two quarters of 2024, burnout rates have dropped even a little further down to 45%.
Unger: Well, that is great news. And why don’t we dig a little bit deeper into the data. The report also looked at six key indicators of physician well-being. What were some of the top takeaways when you look at that kind of data?
Dr. Sinsky: Yeah, well, let’s look at two of those. One is the amount of stress that physicians report because of their job, and one is feeling valued. And what we find is about half of physicians feel stressed because of their job, but it’s not what some people might think. It’s not because of the hard work of taking care of sick patients. It is hard work, but that’s what physicians signed up for. That’s what we went through all the training for. That’s actually what gives us meaning and purpose.
But the stress, I believe, comes from spending our time doing the wrong work. From things that get in the way of taking the very best care we can of patients. So one of the top reasons that physicians report stress is that there’s not enough support staff. So physicians end up, then, doing work that other team members could do if there were more support staff, and that means we can’t offer the same level of care to our patients or the same care to as many patients as we would if there was adequate staffing. So that’s one of the big sources of stress.
And the other is that there’s just too many administrative tasks to be done. Things that the AMA is working on, like reducing prior authorization, should be able to help with some of those additional administrative tasks that contribute to stress.
Unger: And these are both, of course, areas that you and your team are working very hard on. I’m curious if you think that the positive trends that we’re seeing now and that look like they might be continuing into the following year, do you think that’s going to continue maybe as we get farther and farther away from the pandemic? Or what do you think is at work here?
Dr. Sinsky: Right. It looks like the pandemic was responsible for a peak in burnout rates in our study, and actually in other national burnout studies that we’ve been involved with. But some of the fundamental sources of burnout for physicians existed before the pandemic, and they persist after.
Physicians feel like we spend more time interacting with the computer than with the patient. And we know that that’s actually literally true. And physicians in some specialties spend an hour or two every night on pajama time doing work on the electronic health record after hours, stealing time away from their time with their families and their friends. And all of the administrative burdens, as we mentioned, for prior authorizations, all of those persist. So things are improving, but we have work to do.
Unger: Absolutely. And you’ve got the general trends that we’ve talked about right now, but the report also looked at the rate of burnout by specialty. Is there anything notable when you look at which specialties seem to rise to the top in terms of the highest levels of burnout?
Dr. Sinsky: Right. Well, Several things. Emergency medicine has been near the top in the last several years, and that actually makes sense based on the nature of the work that is done in the emergency room and the fact that the pandemic really hit the emergency room hard, particularly in the first couple of years.
The other specialties that tend to be toward the top are the people who are on the front lines of care. The primary care physicians, our OB-GYNs, our pediatricians and our hospitalists, people who are spending most of their time directly taking care of patients.
Unger: Do these trends seem to—these by-specialty trends stay consistent, or are we seeing kind of shifts in that?
Dr. Sinsky: Yeah. So for the primary care physicians, that’s been pretty consistent. But we saw something really interesting in hospital medicine, where in 2022, 59% of physicians—nearly 2 out of every 3—were reporting feeling burned out. And that’s dropped to less than half now, 44%. And again, I think that makes sense given the nature of the exceptional stress that our emergency room physicians faced during the pandemic.
We also found that some of our other specialties, pulmonary critical care being another one, one that’s in the ICU, those specialists had a great deal of stress during the time of the pandemic. Understandably so.
Unger: We’ve got to feel somewhat encouraged to see data like this. The AMA, of course, have been so hard at work developing research, like finding that figures you talked about with pajama time or even how much time folks are spending on computers versus in patient care, identifying system-level procedures and that are driving that kind of additional burden.
Obviously there’s a lot more here to do, Dr. Sinsky. As the leader in physician well-being, the AMA’s got a lot of work on all fronts. Talk to us a little bit about those efforts and what you see for the coming year.
Dr. Sinsky: Sure. So we continue to do founding work in research. So that all the recommendations that we make are based on evidence to the best that we can. And one interesting piece of evidence that’s risen to the top lately is the importance of feeling valued. And currently, only about half of our physicians said they feel valued, although that’s higher than it had been in the previous years.
But we know that when organizations convey the sense that they value their physicians, that can be a striking mitigator against burnout, and also against turnover. So when physicians feel valued, they’re much less likely to leave the organization, and that’s really expensive.
We have a few other things. We’ve got resources that we’ve made available. The latest playbook is called “Check the Rules Playbook.” And in this, we debunk some of the regulatory myths that add further time and sludge to physicians’ day, sometimes unnecessarily. So that’s a resource that physicians and their administrative leaders can review together and hopefully implement some of those sources of stress.
And then we’ve got some great meetings coming up. We have a Saving Time Boot Camp—it’ll be our third Saving Time Boot Camp—where physicians and their administrative partners from around the country come together for a couple of days at the AMA Headquarters to learn tips and tricks to make the work more efficient, to help the teams glue together better and work together better.
And then in October, we have the International Conference on Physician Health. We host this every other year in conjunction with the British and Canadian medical societies. And so that’s another big event where researchers and leaders from across the world come together to share what they’ve learned and where they’re going to improve professional well-being.
Unger: It truly is a global movement to improve physician well-being. Dr. Sinsky, thank you so much for joining us, and of course, to you and your team for all the work you’re doing to improve physician well-being. We’ll include more information about those efforts in our burnout report in the episode description.
To support more work to improve physician well-being, there is something you can do, too, and that’s to become an AMA member at ama-assn.org/join. That wraps up today’s episode. We’ll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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