Two in five U.S. physicians feels burned out, according to the Medscape National Physician Burnout & Depression Report for 2018.

This year, Medscape explicitly adds the condition of “depression” to its important study, and its title. In 2017, the Medscape report was about bias and burnout.

Physicians involved in primary care specialties and critical care are especially at-risk for burnout, the study found. One in five OBGYNs experience both burnout and depression. Furthermore, there’s a big gender disparity when it comes to feeling burned out: nearly one-half of female physicians feel burnout compared with 38% of male doctors.

Being employed by a health system or self-employed doesn’t appear to make a difference in burnout: equally, 42% of physicians feel burned out whether self- or system-employed.

Above all factors, it’s the job that burns physicians out, as opposed to finances, family, love life, or personal health.

Burnout and depression impacts how physicians deal with both colleagues and staff as well as patients. One-third of physicians who are depressed say patients “exasperate” them.

What contributes to physician burnout? the survey asked.

It’s onerous bureaucratic tasks — think EHR implementations, paperwork, insurance company hassles, and time away from hands-on patient care — feeling like one is working at their highest-and-best use.

“Exercise” is the most popular self-care tactic used by one-half of physicians to deal with burnout and depression.

In the meantime, note that only 9% of male doctors and 13% of female clinicians are currently seeking help to deal with their burnout/depression, Medscape found.

Health Populi’s Hot Points: Of all the surveys in healthcare we could learn from in 2018, this will be one of the most important.

Many of us working in healthcare have added a fourth leg to the Triple Aim stool: in 2018, we must attend to the Quadruple Aim, which calls out the challenge of clinician burnout as a key factor in helping make healthcare better.

In 2014, Dr. Thomas Bodenheim and Dr. Christine Sinsky talked about the Quadruple Aim in this seminal discussion in the Annals of Family Medicine. They wrote about, “care team well-being as a pre-requisite for the Triple Aim.”

Furthermore, Bodenheim and Sinsky noted that, “The barriers to achieving the Triple Aim include improving population health in a society experiencing obesity and diabetes epidemics and growing income disparities, rising health care costs, and a dispirited and disengaged health care workforce…Health care is a relationship between those who provide care and those who seek care, a relationship that can only thrive if it is symbiotic, benefiting both parties.”

Ultimately, what benefits physicians and nurses benefits patients: we are in a shared health commons. Any healthcare reforms that diminish the importance of either clinician or patient in health care work- and life-flow will do further harm to an already-fragile healthcare system.