20% of doctors want to reduce clinical hours

The prevalence of physician burnout could worsen the shortage of doctors in the U.S., according to an American Medical Association (AMA) survey which found nearly one out of five physicians want to cut back their clinical hours to part-time within a year, while others are thinking of retirement, pursuing a different kind of practice or leaving healthcare altogether.

The results, published in the November issue of Mayo Clinic Proceedings, were strongly tied to feelings of burnout, dissatisfaction with work-life balance and frustrations with Medicare and insurance companies.

“Burnout is more common among physicians than other U.S. workers, and that gap is increasing as mounting obstacles to patients care contribute to emotional fatigue, depersonalization and loss of enthusiasm among physicians,” AMA President David Barbe, MD, MHA, said in a press release. “The AMA is urging Congress, hospitals, and health plans to recognize the coming crisis as an early warning sign of health system dysfunction. America’s physicians are the canary in the coal mine.”

Among the survey’s key findings from the 6,695 practicing physicians who responded:

• 19.8 percent said they planned to switch to a part-time clinical schedule within a year.
• The most common reason for cutting back was to spend more time with family (28.6 percent of those considering reducing their hours), followed by frustration with Medicare and “insurance issues” (14.6 percent). 10.1 percent cited declining reimbursement.
• 26.6 percent said they planned to leave their current practice within two years. When these departing doctors were asked for a reason, 37.4 percent said retirement, 35.2 percent said pursuit of a different practice opportunity , 9.7 percent said pursuit of an administrative role and 7.4 percent said they plan on switching to an entirely different career.
• Roughly 2 percent of the entire cohort, 126 physicians, said they plan to leave clinical practice altogether.
• 24.8 percent reported working between 50-59 hours per week, 22.7 percent reported working 60-69 hours per week and 15.6 percent reported working 70 hours or more.

Of the physicians who intend to leave their current practices within two years, 35 percent are already working less than 40 hours per week. Compared to the doctors who are looking to reduce their hours, the departing physicians reported being more dissatisfied with their electronic health record or computerized physician order entry.

“These findings have potentially profound implications for the adequacy of the US physician workforce,” AMA’s vice president of professional satisfaction, Christine Sinsky, MD, and her coauthors wrote. “Reduction of clinical work hours results in reduced access to care for patients and thus has a direct effect on the adequacy of physician supply. Leaving current practice, even for another practice, erodes continuity of care and results in reduced access during the transitions, as the physician is either ramping down capacity in their old practice or ramping up in their new practice.”

The need for regulators and the industry to address the underlying causes of physician burnout has been repeated by dozens of major medical groups. There’s also a financial benefit, with a recent JAMA Internal Medicine study finding a $1 million investment in anti-burnout initiatives saves healthcare organizations $1.125 million.