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The new health threat? Burnout, and suicides, by physicians

María Molina leans about air management with help from Dr. Anthony Lim during a Reaching Out to Aspiring Doctors conference at the UCSF Fresno Center.
María Molina leans about air management with help from Dr. Anthony Lim during a Reaching Out to Aspiring Doctors conference at the UCSF Fresno Center. Fresno Bee file

Who needs a happy MD? We all do.

More than one doctor a day dies by suicide in the United States and untold numbers of physicians burn out and leave the profession every year.

In a recent 2019 Medscape survey, more than 50 percent of the 15,000 physicians from across the country who responded reported symptoms of burnout or depression. Rates of burnout were highest among our front-line physicians, including family medicine, obstetrics and gynecology, internal medicine and emergency medicine.

dr. lori
Dr. Lori Weichenthal is assistant dean for graduate medical education at UCSF Fresno. UCSF Fresno

This epidemic of physician burnout, depression — and suicide — is tragic for physician families and their medical communities, as well as patients and society. A recent report by the Massachusetts Medical Society, the Massachusetts Health and Hospital Association and the Harvard T.H. Chan School of Public Health called physician burnout a public health crisis.

Consider these repercussions: Burnout has been linked to more medical errors, less patient satisfaction with their care, and more health-care providers leaving the profession to find work in other arenas.

Let’s look at this possibility of health care providers leaving their profession and how it plays out in the San Joaquin Valley. The Valley has one of the lowest ratios of primary-care providers as compared with other regions of California. There are 133 active physicians (excluding medical residents) per 100,000 population, compared with the state rate of 222 active physicians per 100,000 population, according to a Healthforce Center at UCSF report. The situation will only worsen in the coming years. Thirty percent of physicians in the Valley are over the age of 60 and are expected to retire within the next decade.

In 10 years, California is expected to have a shortfall of up to 4,100 primary-care clinicians, according to the California Future Health Workforce Commission. Recent studies suggest that by 2030, the entire nation will experience a physician shortage of more than 40,000. Add to this the health care providers cutting their careers short due to burnout, and this truly does look like a health care crisis for the San Joaquin Valley.

Finally, add one more ingredient, one that is not talked about as much. It is estimated that more than 400 physicians die by suicide each year. This is twice the rate of the general population. It is estimated that with the death of these 400 physicians, over 1 million patients lose their doctors. And although not widely reported, many physicians in our Valley have lost their lives to suicide.

What is burning out our health-care providers? It is not the direct care of patients, a special experience that draws most providers to this profession. It is an increased bureaucratic load, more time spent with electronic medical records, long hours and a growing sense of lack of respect and autonomy.

So what is the cure? Recent studies have suggested that the antidote to burnout is engagement. Yes, physicians and other providers need to “practice what they preach” and develop healthy practices that support their well-being and resilience. They also need to feel that they are working in health care systems and a society as a whole that recognizes and supports their work. They need to feel that they are part of the solution to the many health-care issues that all members of our society face rather than just another cog in the wheel of the health-care system.

Physician wellness is a priority at UCSF Fresno. We are committed to creating an environment that is safe, inclusive and supportive. On March 20, 2019, UCSF Fresno will host national expert Dr. Dike Drummond, “The Happy MD,” who will present several workshops for local health-care providers aimed at helping them lower stress levels, build a more balanced life and re-energize their passion for practicing medicine. This event is part of ongoing efforts by UCSF Fresno to promote physician and health care provider wellness. It is a commitment to our community: Happy doctors lead more contented lives and are vital to improved patient outcomes.

Changes will not occur overnight. It begins with everyone understanding that we need happy MDs and health-care providers to be a healthy community.

Dr. Lori Weichenthal is assistant dean for graduate medical education at UCSF Fresno.

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