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In addition, 15% reported being burned out, and 3% reported being depressed, yet about half reported being too busy to seek help for burnout and/or depression.
Those are among the key findings from the Medscape report, which was published online on Feb. 19, 2021. More than 12,000 physicians from 29 specialties, including dermatology, participated in the survey, which explores how physicians are coping with burnout, maintaining their personal wellness, and viewing their workplaces and futures amid the COVID-19 pandemic.
Among dermatologists who reported burnout, 85% said that it started prior to the pandemic, but 15% said it began with the pandemic. That finding resonates with, a dermatologist with the University of Connecticut Health Center, Farmington. “A lot of dermatology practices closed down for a while, which was a huge economic hit,” she said in an interview. “I work for a university, so the stress wasn’t quite as bad. We shut down for about a week, but we canceled a lot of visits. We ramped up quickly, and I would say by the summer more people were coming in. Then we got backlogged. We’re still drowning in the number of patients who want to get in sooner, who can’t get an appointment, who need to be seen. It’s unbelievable, and it’s unrelenting.”
Dermatology trainees were also upended, with many residency programs going virtual. “We had to quickly figure out how to continue educating our residents,” said Dr. Whitaker-Worth, who also directs the university’s dermatology residency program. “What’s reasonable to expect them to be doing in clinic? There were fears about becoming infected [with the] virus. Every week, I had double the amount of work in the bureaucratic realm, trying to figure out how we run our clinic and keep our residents safe but learning. That was hard and the residents were really stressed. They were afraid they were going to get pulled to the ICUs. At that time, we didn’t have adequate PPE, and patients and doctors were dying.”
According to the dermatologists who responded to the Medscape survey and reported burnout, the seven chief contributors to burnout were too many bureaucratic tasks (70%); increasing computerization of practice (47%); insufficient compensation/reimbursement (31%); lack of respect from patients (27%); government regulations (26%); lack of respect from administrators/employers, colleagues, or staff (23%); and stress from social distancing/societal issues related to COVID-19 (15%).
“Even though dermatologists seemingly have such a nice schedule, compared to a lot of other doctors, it’s still a very stressful occupation,” said Dr. Whitaker-Worth, who coauthored aon the topic of burnout among female dermatologists. “It is harder to practice now because there are so many people telling us how we have to do things. That will burn you out over time, when control is taken away, when tasks are handed to you randomly by different entities – insurance companies, the government, the electronic medical record.”
Among dermatologists who self-reported burnout on the survey, 51% said it had no impact on their life, 9% said the impact was moderate, while 40% indicated that it had a strong/severe impact. About half (49%) use exercise to cope with burnout, while other key coping strategies include talking with family members/close friends (40%), playing or listening to music (39%), isolating themselves from others (35%), eating junk food (35%), and drinking alcohol (30%). At the same time, only 6% indicated that they are currently seeking professional health for their burnout and/or depression, and 3% indicated that they are planning to seek professional help. When asked why they hadn’t sought help for their burnout and/or depression, 51% of respondents said they were too busy and 36% said their symptoms weren’t severe enough.
Dr. Whitaker-Worth characterized bureaucratic tasks as “a huge cause” of her burnout, but the larger contributor, she said, is managing her role as wife and mother of four children who are currently at home attending online school classes or working remotely, while she juggles her own work responsibilities. “They were stressed,” she said of her children. “The whole world was stressed. There are exceptions, but I still think that women are mostly shouldering the tasks at home. Even if they’re not doing them, they’re still feeling responsible for them. During the pandemic, every aspect of life became harder. Work was harder. Getting kids focused on school was harder. Doing basic tasks like errands was harder.”
Despite the stress and uncertainty generated by the pandemic, Dr. Whitaker-Worth considers dermatology as one of the happier specialties in medicine. “We still have a little more control of our time,” she said. “We are lucky in that we have reasonable hours, not as much in-house call, and a little more control over our day. I think work-life balance is the main thing that drives burnout – over bureaucracy, over everything.”