Medical Business as Usual is Increasingly Unhealthy


Are we reaching dangerous levels of burnout?


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I interrupt this column’s recent series on the Queen’s death not only out of respect for it being the funeral day, but due to a distressing communication about our own health.

On Friday, Headlines, the daily news briefing of the American Psychiatric Association (APA) summarized a very worrisome report about the level of burnout in physicians in 2021. Leading the news was an article that reported nearly two thirds of responding physicians were burning out in 2021, almost doubling from the year before.1

All specialties, except urology, were reported to have a worrisome increase, especially emergency medicine, family medicine, general pediatrics, and women physicians in general.

As to psychiatrists, I could not find any specific data yet, other than we were in the increasing burnout group. That implies that psychiatry has not yet fulfilled the potential and promise of combating burnout in other specialties.2

I assume these researchers will plan to repeat the next survey at its usual 3-year interval that started in 2011. It would be easy to predict that the results will improve if the pandemic continues to diminish, unless there are other contributing factors like our national divisiveness.

On the promising side, the Biden administration has called for administrative improvement in health care and is providing funds to do so. If not, we will be left with all the negative repercussions the study notes: decreased quality of care; medical errors, clinician turnover, and increased costs. Learned helplessness can also lull us into the complacency that burnout has come to be our new normal.

The main obstacle remains those business-controlled medical systems that block the healing potential of clinicians. The other focus on wellness and what we as physicians can do for ourselves is good, but as far as burnout is concerned, at best it has prevented even worse results. As for the common call for resilience, that can backfire when too much resilience results in staying in an untenable system.

What each of us can easily do that has practical implications is to monitor our own degree of insidious burnout through any of many survey tools or feedback from loved ones. Then we can better make workplace decisions with whatever options we have.

Whereas other countries also have worrisome physician burnout rates, ours is the worst and we are the only one that does not have a national single payer system of some sort.2

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times™.


1. Shanafelt TD, West CP, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life integration in physicians over the first 2 years of the COVID-10 pandemic. Mayo Clin Proc. 2022;97(3):491-506.

2. LoboPrabhu S, Summers R, Moffic HS, eds. Combating Physician Burnout: A Guide for Psychiatrists. American Psychiatric Publishing; 2019.

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