Younger Primary Care Physicians Seeing High Levels of Burnout, Stress

Primary care physicians have faced significant levels of stress since the start of the COVID-19 pandemic, with more than half of physicians under 55 experiencing emotional distress and burnout, according to a Commonwealth Fund issue brief.

The 2022 Commonwealth Fund International Health Policy Survey of Primary Care Physicians reflects responses from practicing primary care providers in the United States and nine additional high-income countries.

In all ten countries, more than half of primary care physicians said their workload has increased since the pandemic started.

With additional workload came additional stress, particularly for physicians under age 55. These younger physicians were more likely to report that their job was very or extremely stressful compared to those aged 55 or older.

In the US, 63 percent of physicians under 55 said their job was stressful compared to 54 percent of physicians 55 or older.

Similarly, younger physicians were more likely to report that they have experienced emotional distress since the pandemic began, including anxiety, great sadness, anger, or feelings of hopelessness. Sixty-one percent of younger physicians in the US experienced emotional distress, while 46 percent of those 55 or older said the same.

“These findings are consistent with research showing that emotional and psychological distress is higher among junior medical staff, even in countries with low COVID infection rates,” the report stated. “The reasons extend beyond the work environment and include the limited social supports that were available during lockdowns and uncertainty around the coronavirus’s life course and its impact.”

Burnout was also more common among younger physicians in all ten countries, with 50 percent of physicians under 55 saying they were physically or emotionally exhausted or felt symptoms of burnout in the US, compared to 39 percent of older physicians.

In nearly all countries, a third or more of younger physicians were experiencing burnout. In Canada and New Zealand, more than half had burnout. The Netherlands and Switzerland were the least likely countries to report physician burnout, the brief noted.

Despite high rates of stress and burnout, few primary care physicians sought professional help for their mental health needs. However, younger physicians were more likely to seek help compared to older physicians in the US (16 percent versus 6 percent) and most other countries.

Physician burnout not only impacts healthcare worker wellbeing but also impedes patient care. Nearly 30 percent of physicians in the US who experienced stress, emotional distress, or burnout said that the quality of care they provide to patients worsened during the pandemic.

While younger physicians experienced burnout and stress at higher rates, older physicians were more likely to say they plan to stop seeing patients in the next one to three years. As older physicians leave the profession, staffing shortages will worsen, and the remaining workforce will likely consist of younger professionals with stress and burnout.

Policymakers and health systems leaders should ensure that physicians have healthy work environments and adequate access to mental health services, the brief suggested.

The American Hospital Association (AHA) recently released its 2023 Health Care Workforce Scan detailing strategies to help health systems recruit and retain workers.

The resource focused on three main areas: reconnecting clinicians to purpose; providing support, training, and technology clinicians need to succeed in multiple environments; and recruiting innovatively, investing in retention, and building a strong pipeline.

Hospitals and health systems should prioritize gathering feedback from workers, strengthening employee satisfaction, and encouraging employees to embrace self-care to help clinicians rediscover the value in their work.

Regarding support and technology, hospitals can leverage telehealth services, pilot new care delivery models, and promote cross-functional professional development.

Finally, AHA said that hospitals should start recruiting internationally, launch nursing programs, increase flexibility within jobs, and advocate for policy changes to improve retention and recruitment.