 So which specialty experiences the most burnout? Well, you'll have to wait and see. Welcome back to the channel, everybody. For those of you who are new around here, my name is Michael, aka Dr. Chlini, and I'm a dual board certified diagnostic and interventional radiologist. Today we are going to be talking about burnout and depression, which is a hot topic that I speak about a lot on my channel. The reason being is that it is very important in the health care space. And the way we are going to do that today is go through the medscape physician burnout and depression report of 2023. Now burnout doesn't just affect physicians. It affects all health care workers, but today we're going to be focusing on physicians. So let's get right into the meat of it here. So this medscape report, they pulled about 9,100 physicians across 29 specialties. Many of the physicians had interesting stories about depression and burnout and how it affects them, how they tried to deal with it, and more importantly, how it harms their personal and patient relationships. Right off the bat here, we see that 53% of physicians reported in this study say they experienced burnout, which is up from 42% back in 2018. Furthermore, or even more alarming is that 23% of physicians are depressed and that is up from 15% when compared to 2018. And this doesn't seem to be trending in the right direction. So what about burnout by specialty? Let's go to the next graph here. I think it comes as no surprise here that emergency medicine tops the list as the most burnt out specialty. In fact, 65% of emergency medicine physicians pulled in this report experienced burnout. Radiology is also a little high here at 54% and pathology and preventive health come in at the bottom at 37%, which makes sense. But looking at a little closer here, we have 57% of family medicine docs who experienced burnout, which is compared to 47% in 2018. Again, all these trends are in the wrong direction. And to be complete here, only 45% of ER docs were burnt out in 2018 compared to 65% now. That is a very significant jump. We're talking about the vast majority of people being burnt out who are ER physicians. Now I'm certain that COVID has had a huge impact on the burnout rate, especially for emergency medicine physicians, but there's also many other factors that come into play that we'll talk about in a little bit. So what about males versus females? Let's go ahead and go to the next graph here. So burnout affects 63% of female doctors and 46% of male doctors previously 48% and 38% respectively. Again, that's from 2018. Let's go on to the next chart here. And as you can see, 30% have experienced burnout over the last two years. Like this isn't just a new thing. Most physicians just feel burnt out and they don't do anything about it. And more than 30% of them have experienced burnout for greater than two years. And that could be five years, 10 years. Who knows? All right, so now let's get into the nitty-gritty here. Let's talk about what are the most important factors for burnout according to physicians pulled in this report. Let's start at the bottom here and talk about the least contributing factors to burnout. Coming in here and last place is stress from treating COVID patients. Obviously, that's a little lower in 2023 because COVID is kind of not really a thing in the hospital anymore. Just above that, we have government regulations and above that we have lack of respect from patients. I actually didn't think of lack of respect from patients until I read this. And it makes sense honestly, the more patient contact you have, the more this will likely happen and cause more burnout because who wants to deal with lack of respect from patients time and time again every single day. In my field, interventional radiology, I experience pretty low patient contact, but I've had this happen to me and had lack of respect from patients before, but I usually kind of brush it off. However, if I was in a field like emergency medicine and I had to deal with this all the time, it may start to weigh on me, which clearly it does. Okay, so let's look at the top contributors to burnout according to this report. So coming in at number three is too many work hours. Makes sense. Just above that, we have another lack of respect, but this time from co-workers, which also makes sense. I can't believe so many people experienced this and coming in the top is no surprise, too many bureaucratic tasks. Now I know that top one hits different than all of the rest, especially if you're a physician out there watching, you see as physicians, we are trained to take care of our patients. Our patients are our only focus. And that's all we want to devote our time to. The problem is that taking care of patients, talking with patients has all become the thing that we focus on the least because of all these bureaucratic tasks that we have to handle, such as battling with insurance companies to get a medication or imaging study approved. And guess what happens when you spend one to two hours trying to get an MRI approved on your patient? Well, that two hours you wasted still somehow has to fit into your busy schedule, which means you have to limit your patient interaction just so that you can get through your day on time. Or you can just stay super late, but who wants to do that? And if you do stay late, you're starting to get burnt out. And it's just a repetitive cycle. Now what's interesting about these top three contributors is that they are the exact same pre COVID back in 2018. It also tells me that literally nothing has changed since then, what factors led them to burn out. This person says, administration does not take into account the hours we spend on answering patient messages, calls and filling out paperwork. Very true. Alternating day and night shifts leads to sleep deprivation. That's also very true. Although I will say that's very job dependent. I think sometimes in ER, they require you to switch back and forth from night to day, sometimes on internal medicine or hospitalists. I don't think that's very common amongst all specialties is very specialty specific. And it's also very job specific. So you can avoid this stuff if you want to. And then down here, one of the quotes is we're asked to do many different things and there's not enough time to do it all that pretty much sums up being a doctor in a nutshell. I really like this part here too. They talked about, does your personality contribute to burnout? They're trying to figure out if the people getting burnt out have a specific personality type. And that's probably somewhat accurate. I love this line here. My perfectionism leads to way more charting time after office hours contributing to a worse work life balance. I totally get that. I like to kind of get a jump on the next day. I like to start off the next day fresh. So sometimes if I have to read cases the next morning before I start my shift, I'll just read them the night before. And you know, it's more work that night. So I have to come home after working and then read a few more studies at night. But I do that for myself because I like to start off with a clean slate almost every other person I work with just does it in the morning. But I don't know why I do it probably contributes to burnout. Alright, so this is another good chart here burnout by work setting outpatient clinic is no surprise to be the highest associated with burnout followed by a hospital about halfway down at 55%. And it looks like office based solo practice is the least likely to contribute to burnout, which makes sense. And like one doc says, I can choose my cases spending adequate time with each patient as clinically indicated without productivity pressures dictated by an external system. That's what makes working at an office based solo practice way better than some outpatient clinics or even hospitals. You can kind of do what you want to do because you're your own boss. So that makes complete sense. And how does burnout affect your life? While I'm frequently in a bad mood, I don't feel like doing anything or going anywhere, aka leading to depression. I isolate more and I feel too fatigued to have an active social life. Again, leading to some sort of depression, I become a negative person, which I didn't used to be again, leading to this sort of burnout mindset here, everything's negative, your life sucks, work sucks, and it just kind of spills over into every aspect of your life. Burnout's real. Fast forward here and now let's talk about how burnout affects relationships of physicians. I'll read off a few here. I've no more time for friends and my wife is always frustrated with me. I see that very common. I mean, how many times have you heard of a divorced physician happens quite a bit. Let's put a strain on my marriage and my family life because I'm irritable and short tempered. Even the dog avoids me. My son hates me for not being around. Again, this is all things I've talked about on my channel because I think it's so important to have a work life balance. Work life balance is the key to not being burnt out. I preach that so much on this channel. I think it's so important and how do physicians cope with burnout? Unsurprising to me, the exercise is the top of this list. I think it's very important and it can help you get in a good mood when you're not in a good mood. Sometimes I wake up cranky, I'm tired, I'm burnt out, then I go work out and I get those endorphins going and I'm so happy the rest of the day at work. It's incredible how much it affects your life just going to the gym. What I don't like seeing on this list is some of the stuff towards the bottom. We have alcohol, prescription drugs, smoking, cannabis use. These are all things you don't want to see physicians use as coping mechanisms because you're just not going down the right path. I don't think I need to highlight too much more on that. So now that we've got the contributors down and what's causing all of the burnout, how do we fix it and what would help the most to help your burnout? And again, it may come as no shocker. The number one answer is increased compensation because if you're actually paid your worth, maybe you won't be as burnt out. Maybe you won't mind spending those extra hours charting. Maybe you won't mind going into the hospital on call if you're compensated well. And I think this doctor in the article sums it up best. I'm just going to read this paragraph off real quick. They really hit the nail in the head with this one. The comment about increasing salaries probably reflects the changes in the way physicians are being employed. More physicians are becoming employed by health systems and proportionately fewer are in independent practices where if they want to earn a greater salary, they can just adjust their work hours or style to do so. These options are less available to employed physicians who are working many more hours than they are paid for but with no financial reward. Hence their only option is to ask for a raise or at least make them feel somewhat respected and valued and less used. The financial recognition here hence becomes a sign of value and respect from their employer, not just their financial worth. Again, this is kind of like if you become an employee of a hospital in this kind of setting, you kind of are at the mercy of your boss versus someone who is working in a private practice. If you work at a hospital and are employed with a hospital to make more money, you would just have to work more but oftentimes you just work more and aren't compensated for it. Hence burnout. Alright, so with all this talk about burnout getting worse over the last five years or so, let's talk about what measures we have taken to help alleviate burnout. We have reduced work hours, we meditate, change job or work setting, sold a practice or put one up for sale and as one doctor in the article says here, even though these all help, it is important to note that the individual solutions to systemic problems will only be a temporizing measure. And I think that's key to this entire topic we are talking about. This is a systemic issue. So anything we do individually to help alleviate burnout doesn't necessarily attack the greater systemic issue as a whole. We need to identify systemic issues that must change in order to create a better working environment for doctors. Now this next chart really gets me here. This is talking about the percentage of physicians who are depressed. So it says 67% of physicians feel depressed and 24% of physicians are clinically depressed or have severe depression. I think it's pretty obvious to say here that this is not good, especially when year over year we've seen many physicians take their own lives because of their depression. And it seems that 51% of physicians say that their depression does not affect patient interaction. And this is what scares me the most because what's actually happened is all that sleeplessness, anxiety, depression, irritability, all of that stuff is getting suppressed and bottled within the physician because when they see their patients they have to exude confidence. So what happens is they bottle it all up, bottle it up, bottle it up, they can never get it out and it just compiles on itself and gets worse and worse and worse and eventually the physician cracks, which ends up being worse for the doctor and also the patient. There's a lot of overlap between burnout and depression and I really think it's the reason why we see so many physicians playing their own lives. So I thought this was a very interesting article and report and hopefully you all stayed with me through it. I know some of it is really dry, but I think it's important we talked about this because just got to get it out into the atmosphere and hopefully we can make some systemic changes to prevent burnout going forward. And I'd be lying if I said I haven't experienced burnout myself, obviously in training it's very grueling, the hours are long, you get burnt out. Even into my job, I've been here almost two years now, the hours are way better, but still you have to read a lot of studies. It can get pretty exhausting and you can experience some sort of burnout and in radiology we kind of experience burnout in different ways over the past 20 or 30 years or so. Radiology has just gotten busier and busier and our reimbursements for reading studies have gotten less and less, having to keep reading more to get paid less and it's just this never-ending burnout cycle. But every field has their own unique set of challenges and different ways that cause burnout. The point I'm trying to make with all of this is that there are systemic issues that plague medicine and promote burnout, which is the exact opposite environment that we as physicians need in order to take care of our patients. We must continue to work together to figure out how to ameliorate burnout altogether and take back our intended role as healers. And that's all for this video, make sure you smash that like and subscribe button, follow me on Instagram and TikTok if you don't already. If you have any questions, leave them in the comments below and I'll try to answer any of them or all of them if I can. As always, I'll see you all on the next video. Bye.