Which Specialties Experience the Highest Rate of Burnout, and is the Affordable Care Act Driving This?

Medscape recently conducted a survey to figure out which physician specialties are experiencing the most burnout, and more importantly, why? Sifting through the data shows us that the doctor’s interactions with their patients is not the root cause, as most people would think. The issues at hand are the following:

1. Too many Bureaucratic Tasks
2. Spending too many hours at work
3. Present and Future impact of the Affordable Care Act
4. Feeling like a cog in the wheel
5. Income not high enough
6. Lack of professional fulfillment
7. Inability to provide patents with quality care they need
8. Too many difficult patients
9. Increasing computerization of practice
10. Difficult colleagues and staff
11. Compassion fatigue.
12. Difficult employer.

Lets dive into a few of these and try and pinpoint what may be driving this. The ACA ranks as the number 3 cause physicians give for burnout, but should it be the number one reason? The independent physician ranks are dwindling because the ACA encourages hospital systems to buy up practices and roll them into their umbrella. When you look through the above 12 reasons the following could be directly related to President Obama’s healthcare overhaul: Feeling like a cog in the wheel, income not enough, lack of professional fulfillment, inability to provide patients with quality care they need, increasing computerization of practices, and difficult employer. It’s not a stretch to think that the ACA is having a dramatic impact on physicians across the nation.

ACA causing physician burnout?  (Image Source: Medscape)

What can be done to reverse these trends? Well, there has been a huge push from doctor organizations to repeal the ACA. Congress has tried to repeal it 30+ times, but that seems more of political posturing then anything. Even if Congress were to get enough votes, there is no way that the President would sign it……there’s a 100% guarantee he would veto is. There has also been talk about Congress just not funding portions of it, causing it to collapse on its own. We do think that healthcare needs to be reformed, but at what cost? We firmly believe that we need to not just have health insurance companies and politicians sitting around a table figuring out what’s best…..but we need physicians there as well. Lets be clear, we NEED practicing physicians to have a voice, not just the physician turned politician.

Here is the list of specialties with the highest rate of burnout:
10. (tied) Orthopedics
Burnout percentage: 40%
Severity: 3.6 (fifth from the bottom)

10. (tied) HIV/Infectious diseases
Burnout percentage: 40%
Severity: 3.7 (middle of the pack)

10. (tied) Nephrology
Burnout percentage: 40%
Severity: 3.8 (relatively low)

8. (tied) Urology
Burnout percentage: 41%
Severity: 3.9 (tied for third with six other specialties)

8. (tied) Neurology
Burnout percentage: 41%
Severity: 3.8

4. (tied) General surgery
Burnout percentage: 42%
Severity: 3.9

4. (tied) Anesthesiology
Burnout percentage: 42%
Severity: 3.8

4. (tied) Internal medicine
Burnout percentage: 42%
Severity: 3.9

4. (tied) Ob/Gyn and women’s health
Burnout percentage: 42%
Severity: 4.1 (ranked first for most severe)

3. Family medicine
Burnout percentage: 4.3%
Severity: 3.9

2. Critical care
Burnout percentage: 50%
Severity: 3.9

1. Emergency medicine
Burnout percentage: 51%
Severity: 3.8

We’d like to hear from you, do you think the ACA should be the number one reason for physician burnout?