1 in 3 US cardiologists report burnout: ACC survey
Physician burnout is a growing issue in cardiology — especially among women and mid-career cardiologists — despite efforts to alleviate job-related pressures, according to the latest results of the American College of Cardiology’s 2019 Burnout Study.
Among survey respondents, 35.4% of U.S. cardiologists reported feelings of burnout and 43.9% reported feeling stressed. One-quarter of the cardiologists who reported burnout cited experiencing one of more symptoms of burnout — including physical and/or emotional exhaustion, personal sense of lack of accomplishment, and cynicism and detachment — and 9.9% reported chronic burnout and work frustrations.
In addition, 1.6% of respondents reported complete burnout.
The prevalence of burnout in cardiology “increased by 32% since 2015 and that is concerning,” Cardiology Today Editorial Board Member Laxmi S. Mehta, MD, chair of the ACC Membership Committee’s Well-Being Workgroup, director of preventive cardiology and women’s cardiovascular health at Ohio State University, said during a presentation at the virtual ACC Scientific Session.
Prevalent burnout, stress reported
The ACC survey was sent to 14,348 cardiologists in fall 2019. Mehta and colleagues reported the data from 2,025 cardiologists (1,652 men) who completed the survey and answered questions to assess burnout as well as newly added questions about medical errors and desire to change jobs.
- Change over time: The prevalence of cardiologists reporting no burnout decreased from 23.7% in 2015 to 20.7% in 2019, while the prevalence of cardiologists reporting burnout increased from 26.8% to 35.4%.
- Sex: More than 45% of female cardiologists reported burnout compared with 33.5% of men (P < .001).
- Career stage: Burnout is most common among mid-career cardiologists (8 to 21 years of experience; 45.3%), followed by early-career (35.4%) and later-career (31.5%) cardiologists (P < .001).
- Work hours: Burnout increases with more hours worked. Burnout was reported by 41.5% of cardiologists who report working 60 or more hours per week, 29.5% working 40 to 59 hours per week and 17.9% working less than 40 hours per week (P < .001).
- Work environment: Among respondents who report a hectic work environment, 59.5% reported feeling burned out, 32.3% stressed and 14.6% no burnout (P < .001).
Almost 9% of cardiologists reported concern that they may have made a major medical error in the past 3 months, Mehta said. Of those, 58% were burned out and 33% were stressed (P < .001).
More than 15% of cardiologists reported plans to leave their current practice setting, with the highest rates among cardiologists who were burned out (58%) or stressed (33%; P < .001). Reasons for planning to leave the current practice setting among burned-out cardiologists included desire to spend more time with family, call, excessive RVU targets, electronic health records and pressure to maintain high patient satisfaction scores.
Mehta noted that the survey response rate was just 14% and that burnout was self-reported and may vary over time. However, she said, the findings are consistent with other national surveys.
Looking ahead, Mehta and colleagues plan to examine how stress and burnout affect the full care team and identify factors that can predict burnout, and then work with the ACC to address potential solutions. In addition, she said, it is important to focus on the groups that are highly impacted by burnout.
In particular, “women and mid-career cardiologists are at the highest risk of burnout, and we need to turn some further attention to these populations,” Mehta said.
Burnout in the age of COVID-19
“Given the current COVID-19 pandemic, we are cognizant of the panic, fears and high level of stress among all health care workers,” Mehta said.
During a discussion of the study, panelist Sandra J. Lewis, MD, cardiology specialist at Legacy Health in Portland, Oregon, said it is “hard to avoid the elephant in the room today, which is COVID-19, and the importance of burnout is really front and center with our colleagues who are working long hours, have a hectic work environment, lack of control and, more than that, a lack of safety ... and as we see our colleagues falling victim to this. It’s going to be a challenge to help us through the burnout we’ll see at the end.”
Mehta presented several “self-care strategies during the age of COVID-19”:
- Relinquish control
- Revisit history
- Establish realistic expectations
- Give yourself a brain break
- Unplug from the noise
- Find a state of flow
- Your body matters
- Pay it forward
- Find your tribe
More information can be found at the ACC’s Clinician Well-Being Portal, and resources for physicians on the front lines of the COVID-19 pandemic can be found at the ACC’s COVID-19 Resources for Clinician Well-Being page. – by Katie Kalvaitis
Mehta LS. Featured Clinical Research I. Presented at: American College of Cardiology Scientific Session; March 28-30, 2020 (virtual meeting).
Disclosures: Mehta and Lewis report no relevant financial disclosures.