By Josh Katzowitz, WCI Content Director
One of our big goals at The White Coat Investor is to prevent physicians and other high-income professionals from becoming burned out. If you suffer from burnout and leave the job you spent so long training for, you lose the ability to earn a high salary, to save tons of money, to invest a high percentage of your earnings, and to retire to a life you want to live.
Recognizing the signs of burnout is important, and taking steps to prevent it from happening to you (either through financial planning, diversifying your income, or attending WCICON25 to breathe in all the wellness content and activities) is key to keeping yourself on a financially fruitful path.
And it probably would be helpful to know what medical specialties tend to suffer from burnout the most.
According to the 2024 Medscape Physician Burnout & Depression Report, 63% of emergency medicine doctors have felt burned out—the most of any specialty—and they’re followed by OB-GYNs (53%), oncologists (53%), and pediatricians (51%).
“It’s interesting to me that these are all front-line specialties, delivering primary care either predominantly or frequently,” Dr. Lisa MacLean, the chief clinical wellness officer with Henry Ford System in Detroit, said, via Medscape.
In the 2023 Medscape survey, EM was at 65%, internal medicine at 60%, and pediatrics at 59%. The fact that all those numbers declined for 2024 is a positive sign, and it’s also good news that, in the 2024 survey, 49% of total doctors said they felt burned out compared to 53% in 2023.
The pandemic-induced burnout signs seem to have declined, but Dr. Heather Farley also noted that “the pandemic-related stressors have been replaced by new and exacerbated stressors in the form of financial pressures, which have many health systems making fewer people do more.”
Female doctors continue to report burnout at higher rates than male doctors. In 2024, 56% of female doctors said they felt burnout symptoms (down from 63% the year before), while 44% of male doctors reported the same (down from 46% in 2023). Some of the reasons women report higher rates of burnout than men, according to Farley, are differences in pay, different levels of resources, fewer women in leadership positions that can advocate for them, and more challenges to work-life balance because of childcare responsibilities.
“It’s not easy to close that gap,” she said. “We have much work to do.”
And it’s not as if these burnout symptoms come and go in a timely manner. Twenty percent of doctors said their burnout has lasted between 7-12 months, 29% said between 13 months and 24 months, and 42% said longer than two years. Meanwhile, 16% of women and 14% of men said their burnout symptoms were so severe that they were considering leaving medicine altogether.
The No. 1 reason physicians said they were burned out: bureaucracy.
Perhaps the biggest question, though, is how can physicians cope with burnout and perhaps soothe their wounds in a healthy way. While a tiny minority of survey respondents say they use marijuana, nicotine, and prescription drugs to cope, 33% say they eat junk food, 24% drink alcohol, and 21% binge eat. In more positive news, 52% say they exercise, while 49% report talking with friends and family.
As WCI columnist Julie Alonso wrote in a recent column on Strengthening Your Mental Health:
“There are no shortcuts to supporting your well-being. It’s an ongoing process across a lifetime that requires continued attention . . . In my clinical work, I do a lot of lifestyle counseling and short-term goal-setting with patients, and I have seen it pay off. I also try my hardest to practice what I preach. I know there are no workarounds to getting enough sleep, eating a wholesome and nutrient-rich diet, doing regular physical activity, and getting enough social engagement. It’s even better when I can combine more than one of these areas.”
It seems, though, that getting professional help might be a step too far for some. While 26% of those suffering from burnout or depression said they had or would seek it out, a whopping 53% said they hadn’t gotten professional help in the past and wouldn’t in the future.
As WCI founder Dr. Jim Dahle has written in the past, “Burnout is your greatest financial risk.” While the numbers in the Medscape burnout survey are moving in a positive direction, the burnout pandemic among physicians doesn’t seem likely to fade away anytime soon.
More information here:
How My Burnout Led to Rage That Could’ve Ended My Career
What Are the Most (and Least) Stressful Medical Specialties?
Understanding Veterinarian Burnout and Mental Health
Money Song of the Week
This week, we have a reader suggestion from commenter Talon, who writes this about Faster Horses (The Cowboy and the Poet) by Tom T. Hall: “It’s a clever, albeit nihilistic song about money with some classic country twang.”
I’d never heard the 1975 tune, and I didn’t know anything about Tom T. Hall, who was one of the most popular country artists in the 1970s. The song follows a discussion between a cowboy and a poet. The poet is idealistic and probably a little naive. The cowboy is cynical and probably a little mean. The cowboy says life is all about whiskey, women, and money (not unlike what the Grackles sang about in Tonight’s My Night to Howl). The poet says he doesn’t care about any of that.
That doesn’t sit well with the cowboy. As Hall sings,
“I told him I was a poet, I was lookin' for the truth/I do not care for horses, whiskey, women or the loot/I said I was a writer, my soul was all on fire/He looked at me and he said, ‘You are a liar.’”
After the cowboy kisses the poet’s head with “somethin’ cold and shiny,” though, the poet begins to better understand the cowboy’s point.
Hall, who died in 2021, is beloved by the country and western music community, and people cite his storytelling as one of his greatest attributes. But he said he was always careful not to cast aspersions on the characters he sang about, about what they wanted, or about what they felt were the most important things in life.
“I never made judgments in my songs,” Hall told NPR, via Country Reunion Music. “I had a lot of good characters, a lot of bad characters. But I never bragged on the good guys and I never condemned the losers.”
Whether drinking whiskey and prowling for money makes you a good guy or a loser is up for interpretation, I suppose.
More information here:
Every Money Song of the Week Ever Published
Instagram Reel of the Week
No matter what you think about credit card rewards and travel hacking, there's one thing that is for sure: playing AC/DC on your social media is always a winning move.
Do you think the burnout problem can get better for physicians (or can even be resolved)? How have you dealt with burnout? What else can doctors do?
[EDITOR'S NOTE: For comments, complaints, suggestions, or plaudits, email Josh Katzowitz at [email protected].]
37% burnout for plastic surgery sounds bad too. If the best on the list still has 1/3 burnout rate that doesn’t say much good about the medical profession.
How random was this survey? Are burned out people more likely to respond? What’s the baseline rate in other jobs? If you survey McDonald’s workers what is the burnout rate?
No shame in having to work for a living, but sometimes medicine is sold as this rewarding, fulfilling activity rather the realty of often times a tough job. It still beats working night shift CNA at the hospital for 10% or less of the physician hourly rate.
I saw this Medscape survey earlier, and something seemed off. While I agree with the main idea of which specialties are the most stressed, the reasons were mostly overwork and “low money” was not even mentioned. But if you look at the end of the study (not published in this article) they ask what would help the burnout the most, and the number one answer was more money.
I’m not sure how the questions were worded but that seems incongruous.
I am an older family doc who just retired and while it was not due to burnout, I felt most of the stressors mentioned above.
For myself, money was not the issue. It was control over how busy I was. That is number one two and three on the ways to improve the stress in my practice.
There is data out there that shows that once you make a certain amount of money, making more money doesn’t make you happier. Jim wrote about that a few months ago and actually talked about the Medscape question you’re referencing.
https://www.whitecoatinvestor.com/will-more-money-make-me-happier/
Seems to me that people think more money will make us happier, but in reality, it won’t. And if you listen to enough of the Ramit Sethi podcast, he talks about that, like, every other week.
Thanks for pointing that out, and I agree.
Which makes it even more questionable that “higher compensation” is the thing the Medscape docs feel will
fix their problems. I wonder how they asked the question, as in one of the choices being: would you be happier if your salary were doubled from what it is now?
Well that’s actually not true. More money does make you happier. The initial article on this topic did say as you mentioned but was wrong and they redid the study and found mo’ = mo’ happiness. However, once you reach a certain point the gradation of money to happiness decreases significantly so there is less bang for your buck. As Podcaster I listen to says, he is definitely happier when he got his private jet. Ha.
Slope pretty steep to about $100K, not so steep after that. I suspect if it were really studied well, it would level off at some point and perhaps even decline.
For EM – finances play a huge role because your income functionally stays the same or goes down as you progress through your career.
Early in your career, working 18 shifts is easy. With a limited financial understanding, several new grads inflate their lifestyle to where they functionally live paycheck to paycheck.
As they get older, have more family, working 18 shifts becomes really taxing.
Then they are unable to scale back… leading to their burnout and finances being a key reason behind it.
Is there data on how many are actually quitting because they are “burned out” vs just saying they feel “burned out” on questionnaire?
I haven’t seen it, but agree it would be interesting. Reminds me of the old quote about burnout:”Hate your job? There’s a support group for that. It meets at the bar on Friday nights.”
Derm ???
Give me a break.
What are these people thinking when they go to med school? It’s gonna be a cakewalk? These people who are going into ER, didn’t they do rotations through the ER in a busy center before they applied to do a residency? People that went into OB/GYN, don’t they realize that people don’t have babies on a schedule? I’m sorry, medical schools are admitting the wrong people.
I’m a psychiatrist who is not burned out in the slightest. I have a fantastic job. I have avoided burnout like this:
1. I have always been an employee, never a business person. I am pretty bad with business and billing. I prefer to work my contracted hours and get paid on a schedule. I have paid time off and I take it. When I’m away, I’m away (mostly). My benefits and retirement plans are part of my work structure too. I have never depended on private practice to make a living. When my patients tell me “you don’t care about me, you just care about getting paid,” I can truthfully answer, “I don’t even know if you have insurance or whether it paid us or not. I’m here to help, regardless, and I get paid regardless.” They are generally surprised to learn this.
2. I have a job that is highly meaningful. I am performing social justice every day, in the public health setting where I work. When I get frustrated, it’s never at the job itself, but at the problems that our social injustices create, and my team and I are united in our feelings about them. Our shared feelings serve to unite and inspire us.
3. I’m good at my job. My job appreciates me and lets me know on a regular basis. I don’t need to make a ton of money, which I do not; I need to feel useful and valued, which I do.
4. I work with the best people. We communicate well and genuinely respect and like each other, and still maintain boundaries.
5. I do not have to take call.
6. I exercise a lot. It is indeed good for my physical and mental health.
Not everyone wants what I have chosen, but if you choose a specialty that will eat you alive, you shouldn’t be surprised when it does. People who chose their specialty for financial reasons are probably the most burned out. I suspect that most doctors under-emphasize autonomy when they choose their specialty, and if you don’t acknowledge your need for autonomy, or if private equity steals your autonomy by controlling your practice, you will be miserable, because no amount of money can buy autonomy in Medicine. Even concierge doctors…they think they’re buying autonomy but what they are really buying is a richer class of patient who will feel entitled to summon their doctor whenever they want. It’s a different kind of yoke, but it’s a yoke all the same.