PHYSICIAN LIFESTYLE AND HAPPINESS SURVEY

For some reason, professional organizations are overly concerned about physicians’ lifestyles and whether they are a happy lot. Surveys on physician “burnout” are published often. The survey I read most recently was produced by Medscape Internal Medicine, an online information site that reports on new medical treatments and technologies. It also annually asks physicians questions about their financial status and personal satisfaction with their practice. The 2024 survey was called “The Medscape Physician Lifestyle and Happiness Report.” It was published online last year and cited data compiled from 2023. It was the most comprehensive such survey I have read in awhile. 

The genesis of this survey was concern over the ever-increasing number of physicians who leave practice because of “burnout.” Burnout has become a national concern, and those folks, usually not physicians, are seeking to find a reason for it in order to formulate a solution. I will “play their game” and report to you what they say, but “lifestyle and happiness” are a smokescreen that obscures the real problem.

From my perspective, physicians leave the practice of medicine because of the continual assault on their autonomy, their role in professional hierarchy, and their value to the healthcare system. Physicians have been “downgraded” to the role of “provider,” or “prescriber,” while nurse practitioners and physician’s assistants have been granted status equal to that of physicians who have many times more educational experience and knowledge. 

Physicians judgement and authority are continually questioned by 3rd party payers who unilaterally determine if tests and procedures physicians recommend are really necessary. We are constantly second-guessed for ordering any MRI, CT, or other complex technological study we feel a patient needs despite being the only people adequately trained to make those decisions.

Then, the U.S. Congress and the Centers for Medicare and Medicaid Services annually REDUCE the value of physician services and REDUCE the money they pay for the performance of those services. This scheme has been cheating physicians out of adequate payment for more than 30 years, and in the past 20 years has resulted in unsustainable financial situations for many physician practices. 

So, I’ll tell what causes burnout! It not overwork! No way! Physicians LOVE TO WORK. They LOVE WHAT THEY DO! They do it because they want to. NO. It’s the continual lessening of the role physicians play and reduction of the financial value of the services physicians provide in that role. And it’s the successful attempts to takeover the physicians’ role by lesser-paid, lesser-educated medical subordinates whose knowledge and insight are far inferior to that of the decades-long trained physician. 

This survey, capsulized below thus takes on moot importance. As I said earlier, it’s a smokescreen, or veil, which obscures the real reason(s) physicians are not a happy group of professionals. These socially-conscious survey takers have missed the mark completely. But it is my obligation to report their findings, and comment thereupon. I will only report a list of specific statistics and not elaborate on details or reasons. I have related the reasons in prior paragraphs. 

Survey data and statistics follow next.

Demographics of Physicians Surveyed:

  Males 61%   Females 39%

   Age 35 and under 9%

   Age 35-44  21%

   Age 45-54  23%

   Age 55-64  29%

   Age 65 an over  17%

   Married:  Men 85%,  Women 73%

   Divorced:  Men 5%,  Women 7%

   Cohabiting:  Men 4%,  Women 5%

   Describe Marriage:  Good 82%,  Fair 14%,  Poor 4%

   Religious Beliefs Important:  YES 69%,  NO 26%

Physicians Maintain Happiness By:

   Spending time with friends and family 78%-80%

   Hobbies  71%

   Exercising  67% —70% work out at least twice a week. 90% exercise some.

   Resting/Sleeping More  51%-54%

   Eat a healthy diet  48%-53%—21% of all physicians claim a healthy diet

   Alcohol consumed < twice a week  70%.  

   Don’t drink any alcohol  26%

   Losing or maintaining weight  84%

Happiness Outside of Work:

   Before COVID  92%

   After COVID   84%

Vacation Time per Year:

   1-2 weeks  27%-30%

   3-4 weeks  44%-46%

   5-6 weeks  11%-13%

   > 6 weeks  5%-9%

   Important for happiness and mental health

      Very important. 73%

      Somewhat   22%

Those physicians living within or below financial means:

   < Age 39  93%

   Age 40-49  92%

   Age 50-59  92%

   > Age 60  94%

Saving for Retirement:

   Saved the same or more last year  57%

   Saved less than last year  33%

Physician Payment for Services, Adequate?

   All Physicians Say:  Underpaid  61% yes

                                   Overpaid  5% yes

                                   About Right  34% yes

   Physicians Self Opinion: Underpaid  49% Yes

                                           Fairly Paid  51% Yes

Do Work Demands Conflict With Family?

   Very much or somewhat  Men  66%  Women 81%                                           

   Prioritize Family Time < Age 45  97% say very or somewhat

                                      > Age 45  94% say very or somewhat

Specialists With Happy Marriage:

   Pulmonologists  91%

   Family Physicians  82%

   OB-GYN  80%

Do You Work Extra to Boost Income?

   Yes-medically related work  20%

   Yes-moonlight, locum tenens  11%

   Yes-more hours in own office  7%

   No-61%

Physician Net Worth:

   < $500,000   25%

   $500K to $1Million  15%

   $1M to $2M  21%

   $2M to $5M  28%

   > $5M  11%

   Family Phys over $5M  9%

   Peds Phys over $5M  10%

   Int Med Phys over $5M 12%

   Urol Phys over $5M  33%

   Card Phys over $5M  28%

   Derm, Ophth over $5M  23%

You’ll notice one question surveyers never asked was, “Are you happy in the practice of medicine?” Somehow the central theme of the survey, physician happiness, was never asked directly. I’m definitely convinced that today’s physicians are not happy with current state of medicine but are powerless to do anything about it. Physicians are at the mercy of the medical bureaucracy (the CMS) and health insurance companies who set policy and make rules unilaterally.  The physician advocacy organizations (AMA, AAFP, ACS, etc.) are doing little against these groups to improve the standing of the physicians they represent. This situation has been going on for 30 years and will not change anytime soon. 

“Burnout” is just a just a synonym for dissatisfaction. It’s a catchy term that implies, in my opinion, that physicians are over-worked and over-burdened. I know very few physicians  who complain about being over-worked. They thrive on being busy and taking care of peoples’ medical needs, even at 3:00 AM. They do feel over-burdened, however, by the constant effort to regulate, restrict, and replace their authority. The greatest insult, however, is the monetary devaluing of the services physicians provide; devaluing and under-paying to the level of unsustainability. The sad state of the business of medicine is forcing many physicians to retire early, seek alternative practice models, or leave medicine for other vocations. Calling it burnout is socially more acceptable, but it is completely inaccurate. 

Reference: McKenna J. Infographic: How Physicians Strive for Healthy Lifestyle Medscape Int Med 2024 February 20.

McKenna J. Medscape Physician Lifestyle and Happiness Report 2024: The Ongoing Struggle for Balance Medscape Int Med 2024 February 13.

McKenna J. What Makes Doctors Happier At, Away From Work. Medscape Int Med 2023 January 25.

McKenna J. Building a Financial Future: Medscape Wealth and Debt Report 2024. 2024 June 12.

McKenna J. Medscape Physician Compensation Report 2024: Bigger Checks Yet Doctors Still See an Underpaid Profession Medscape Int Med 2024 Apr 12.