A nationwide survey has revealed that approximately one in ten internal medicine physicians in the United States is experiencing high levels of burnout, raising concerns about the sustainability of the medical workforce amid projected physician shortages.
The study, published May 6 in the Annals of Internal Medicine, surveyed 629 internal medicine physicians across diverse geographic regions and practice settings. Researchers found that 9.8% of respondents met the defined thresholds for all three domains of burnout: emotional exhaustion, a sense of detachment, and a feeling that their efforts don't make a difference.
"Understanding burnout in this population that provides general medical care is particularly relevant given the projected shortage of approximately 40,000 primary care physicians within the next decade," noted the research team led by Dr. Nathan Houchens, a clinical associate professor of internal medicine at the University of Michigan Medical School.
Geographic Variations in Physician Burnout
One of the study's most striking findings was the significant regional variation in burnout prevalence. While burnout rates were similar in the Northeast (8.8%), Midwest (8.5%), and South (6.6%), physicians practicing in the Western United States reported substantially higher burnout levels at 15.4% - more than double the rate found in the South.
This geographic disparity warrants further investigation, as understanding regional factors contributing to increased burnout could help inform targeted interventions.
Burnout Transcends Practice Settings
Contrary to what some might expect, the study found no significant differences in burnout prevalence across various practice contexts:
- Community medical centers: 10.1%
- Veterans Affairs facilities: 10.9%
- Academic medical centers: 10.6%
Similarly, burnout rates were comparable between primary care physicians (11.8%) and hospitalists (9.4%), as well as among physicians working exclusively in inpatient settings (8.3%), outpatient settings (11.6%), or both (11.1%).
"Burnout remains prevalent among internal medicine physicians and does not seem to correlate to specific practice contexts," the researchers concluded. This finding suggests that burnout may be driven by systemic factors affecting the medical profession broadly rather than by setting-specific challenges.
Implications for Healthcare Delivery
The study's findings come at a critical time for the U.S. healthcare system, which faces significant workforce challenges. With approximately 10% of internal medicine physicians experiencing high burnout levels, there are legitimate concerns about retention and recruitment in a specialty already projected to face substantial shortages.
Dr. Houchens and colleagues emphasized the need for "systemic interventions that target common, important burnout drivers for internal medicine physicians." Rather than focusing on individual resilience or context-specific solutions, the researchers suggest that addressing physician burnout will require broader structural changes to how healthcare is delivered and how physician work is organized.
The Three Domains of Burnout
The study defined burnout using three established domains:
- Emotional exhaustion: Feeling emotionally drained and depleted by work
- Depersonalization: Developing a detached, cynical attitude toward patients
- Reduced personal accomplishment: Feeling that one's work doesn't make a meaningful difference
Physicians who scored high on all three domains were classified as experiencing burnout. This comprehensive definition provides a more nuanced understanding of physician distress than single-domain measures.
Looking Forward
As healthcare systems continue to grapple with physician burnout, this study highlights the need for comprehensive approaches that address the systemic drivers of professional distress. The researchers call for future investigations to explore interventions that can address burnout across different practice settings, recognizing that the problem transcends specific contexts.
With internal medicine physicians playing a crucial role in healthcare delivery, addressing burnout in this population is essential not only for physician wellbeing but also for ensuring high-quality patient care and a sustainable healthcare workforce for the future.
