ACC: 1 in 4 cardiologists are burned out

A little over a quarter of cardiologists report feeling burned out on the job—something that’s increasingly recognized as a barrier to quality healthcare—according to a recent survey from the American College of Cardiology.

Since the introduction of the “quadruple aim” in healthcare, systems and administrators have been urged to focus on the wellbeing of their clinicians as well as their patients, Laxmi S. Mehta, MD, and co-authors wrote in JACC, on behalf of the ACC Women in Cardiology Leadership Council. But uptake of the quadruple aim has been highly variable, with “inconsistent efforts to address wellbeing across institutions.” 

In an attempt to gather more burnout data specific to cardiologists, the ACC included burnout and job satisfaction questions in its third Professional Life Survey (PLS), which was emailed to 10,798 cardiologists and fellows in training. Around 21% responded to the PLS and 2,274 also completed the Mini-Z survey, an additional measure of emotional exhaustion.

The majority of survey respondents—73.2%—didn’t report burnout symptoms, Mehta et al. said. Of that group, 23.7% said they enjoyed their work, though nearly half said they were under stress and had less energy. The remaining 26.8% of respondents did report burnout, with 19.2% experiencing at least one symptom and 6.4% reporting chronic symptoms. A small minority, 1.2%, said they felt burned out to the point of needing outside help.

Mid-career cardiologists with 8 to 21 years of experience reported burnout most frequently (39%), especially compared with fellows in training, early-career and late-career cardiologists. Women said they were burned out more frequently than men (31% vs. 24%, respectively).

Compared to participants who said they didn’t experience burnout, burned out physicians:

  • Were more likely to be married (79% vs. 85% of the non-burnout group)
  • Reported dissatisfaction with family life more often (30% vs. 10%)
  • Said family responsibilities hindered their ability to do professional work (46% vs. 29%)
  • Spent a greater portion of their time in direct clinical practice (73% vs. 69%)
  • Were less likely to report being treated fairly at work (63% vs. 87%)
  • Felt like their contributions mattered less (65% vs. 88%)
  • Experienced discrimination more often during training or their career (50% vs. 37%)

“Neither cardiovascular subspecialty nor practice setting had an impact on burnout,” Mehta and colleagues wrote. “Overall, all cardiologists were satisfied with their career, but burnout respondents were significantly more likely to report feeling less satisfied with achieving professional goals, financial compensation and level of advancement, and less likely to recommend cardiology as a career compared with no burnout respondents.”

A hectic work environment, misalignment of values, family responsibilities, intent to renegotiate for support staff and insufficient documentation time were all independent factors associated with burnout, the authors reported. People who reported lower rates of burnout also said they were satisfied with their family life, encouraged cardiology to others as a career and were being treated fairly at work. Physicians were 30% more likely to avoid burnout if they had a mentor who served as their “career role model.”

Mehta et al.’s data clashes with some recent reports, including a Medscape survey that found 43% of U.S. cardiologists were burned out or depressed, but the authors said that survey failed to use a validated measure of burnout and was a convenience sample with no defined response rates. Mehta and colleagues did find their numbers for cardiologists were lower relative to other specialties—something they said needs further investigation.

“More than one-quarter of U.S. cardiologists reported burnout, which is increasingly recognized as a barrier to improving healthcare and one that needs to be systematically addressed,” the authors wrote. “By identifying modifiable drivers of burnout, our data may inform efforts to understand the causes of burnout and to design solutions at an individual and organizational level.”