Doctors are an average of 2.5 times more likely to commit suicide than the general public. For medical students and residents, that rate is even higher.
The statistic was a wake-up call for the medical world.
Already, a growing number of doctors were choosing nontraditional careers like locum tenens, but only now was the significance of that movement evident.
By October 2018, two studies on physician burnout and depression had been published in prominent medical journals. While the extent of research on the subject is still limited, these early studies showed that nearly 50 percent of residents reported burnout symptoms once a week or more, compared to the U.S. average, which is less than 30 percent.
While feeling burnt out once a week may seem normal or insignificant, it matters immensely, with Dr. Lotte Dyrbye noting that “physicians who feel burnout this often are more likely to report thinking about suicide, making a major medical error and wanting to leave medicine.”
It’s clear that burnout is a pressing issue, however, what’s not as clear is what exactly causes burnout.
Environmental factors are almost certainly contributing factors, but narrowing those factors down has presented a challenge to researchers, since doctors and residents are less likely to be open about both the burnout they face and the ways in which their organizations contributed to it.
Anecdotally, some physicians have cited other factors such as:
The ways PHYSICIANS PROCESS AND RESPOND TO BURNOUT ARE VARIED. Some, like Dr. Seo, who now leads at an education organization in London, leave medicine completely. For much of the industry, retirement ages are dropping. The average physician retirement age is already nearly 5 years lower than average, but a recent report suggested that burnout and low morale is expected to push the retirement age much younger. Dr. Walker Ray, president of the Physicians Foundation, points out that “Many physicians are dissatisfied with the current state of medical practice and are starting to opt out of traditional patient care roles. By retiring, taking non-clinical roles or cutting back in various other ways, physicians are essentially voting with their feet…to the detriment of patient access.” The third group of doctors is choosing to stay in the field, hoping that infrastructures improve and support systems get better.
For many physicians, none of these are great options. Leaving the field or retiring early is tough after investing years into school and residency, and often involves giving up a life’s passion for service. But staying in a toxic or high-stress position has forboding consequences for mental, physical and relational health. As a result, a growing number of physicians are turning to locum tenens work. By enabling more time with patients, greater work-life balance, more control over scheduling, and more freedom from exhausting organizational bureaucracy, locum tenens is helping physicians stay in their field while eliminating many primary contributors to burnout. Locums work can be an attractive solution to those just starting out as well. Dr. Richard L., a D&Y locums contractor, said that he’s transitioned away from encouraging residents to stay in the academic environment. “Right now, when I’m advising some of the residents that get referred to me to talk about future careers…now that I’ve worked both sides, I actually highly recommend doing locums.”
“The flexibility of the schedule…even though I travel—it allows me to spend more time with my wife and my kids and being at home.” – Dr. David L.
“I have control over my schedule and I’m able to pack all my shifts consecutively so that I have more time off to be with my kids and to travel.” – Dr. Richard L.
“I like to exercise, try to go to the gym five, six days a week. I enjoy spending time with my wife, kids. We do a lot of traveling…I’m from Louisiana, so being stereotypical here, but from Louisiana, I like to cook, so I definitely enjoy being in the kitchen.” – Dr. David L.
“My passions are music—I study jazz piano—writing, creative writing, and exercise…Actually, right now, I’m just starting to train [for Ironman competition] again. Working locums definitely gives me more time to do those passions, for which I’m grateful.” – Dr. Richard L.
There are very real career benefits to working in locums, as well. For residents, locums represents an opportunity to work in desirable locations right out of the gate, while making a higher salary that can quickly pay off medical school debt. Those who have been in their career longer have found that locums work contributes to a well-rounded resume and a wide network. One benefit of locums that Dr. David L. cited was that “[Locums work] keeps you sharp…it helps reduce complacency by working in multiple places and just staying on top of your game.” Another benefit is the ability to find an environment that fits your individual preferences. Dr. Richard L. spoke with D&Y about the contrast between his current placement and a previous one: “I’ve worked in places where people are just bitter. And here, patients are treated the way I would like if my parent, my mother, or family member came in…the fact is, patients are really provided great care, and it’s super efficient.”