Physician burnout and job dissatisfaction have intensified over the past two decades due to systemic changes like the HITECH Act, the increased burden of electronic health records, and the consolidation of healthcare systems. These factors reduced physician autonomy and time with patients. The coronavirus disease 2019 (COVID-19) pandemic further exacerbated these challenges, leading to increased workloads, emotional strain, and professional staff shortages. Physicians faced new stressors, including inadequate personal protective equipment (PPE), high mortality, politicized care, and telehealth burdens.
The recent longitudinal study published in Mayo Clinic Proceedings aimed to assess the prevalence of burnout and work-life integration (WLI) satisfaction among US workers and physicians in 2023 in comparison to those in 2021, 2011, 2014, 2017, and 2020.
The 2023 survey employed the same methodology as the off-cycle 2021 study, which had around half as many participants as the other years and the 2011, 2014, 2017, and 2023 studies. The American Medical Association (AMA) physician professional data file was used in this non-incentivized online survey, which covered data from 90,000 physicians. In 2023-2024, participants were selected based on both mailed (n = 3,720) and online surveys (non-incentivized = 83,910 and incentivized = 7,449). A secondary survey of 918 non-responders assessed response bias. Participation was voluntary and anonymous, with some offering $20 incentives.
Physician burnout was estimated by the full-length emotional exhaustion and depersonalization scales of the Maslach Burnout Inventory, depression by the 4-item National Institute of Health patient-reported Outcomes Measurement Information System (PROMIS), and WLI satisfaction by the Stanford Professional Fulfillment Index, with a scale range of 0 to 10. Different statistical analysis methods were employed in this study, such as the Kruskal-Wallis test, t-test, χ2-test, Breslow-Day test, and pooled multivariable logistic regression analysis.
In this study, a non-incentivized online survey was completed in 6288/83,910 (7.5%) physicians, an incentivized online survey in 906/7449 (12.2%), and a mailed survey in 449/3720 (12.1%). About 52/918 (5.7%) individuals responded to a secondary survey of non-responders.
Physicians in the non-responder survey were younger (median age = 46.5 vs. 53 years, P = 0.03) and had fewer years of practice (median 11.5 vs. 20 years, P = 0.01) compared to those in online and mailed surveys.
The demographic characteristics of survey respondents (n = 7643) are comparable to those among practicing U.S. physicians (N = 936,074). However, they were more likely to be female (39.6% vs 37.9%).
The percentage of female physicians rose from 2011 to 2023, and the same was observed in AMA records. In 2011, 30.7% of physicians were women, and the number was increased significantly to 37.9% by 2023. According to non-responder analysis, participant burnout and WLI satisfaction were typical among U.S. physicians. In 2023, 45.2% of participants reported at least one burnout symptom compared to 62.8% in 2021 (P < 0.001), 38.2% in 2020 (P < 0.001), 43.9% in 2017 (P = 0.16), 54.4% in 2014 (P ≤ 0.001), and 45.5% in 2011 (P = 0.49). Satisfaction with WLI was found to be 42.2% (n = 2732) in 2023 compared to 30.3% in 2021 (P < 0.001), 46.1% in 2020 (P < 0.001), 42.8% in 2017 (P = 0.02), 40.9% in 2014 (P < 0.001), and 48.5% in 2011 (P < 0.001).
In pooled multivariable analysis from 2011 to 2023 survey, physicians surveyed in 2023 (odds ratio [OR] = 0.66; 95% CI, 0.61 to 0.71), 2020 (OR = 0.50; 95% CI, 0.47 to 0.54), 2017 (OR = 0.60; 95% CI, 0.55 to 0.65) and 2011 (OR = 0.67; 95% CI, 0.63 to 0.72) had lower odds of experiencing burnout compared to those in 2024. In contrast, physicians surveyed in 2021 (OR = 1.18; 95% CI, 1.06 to 1.22) had higher odds of burnout compared to those in 2014. Moreover, participants surveyed in 2023 had similar odds of being satisfied with WLI as those in 2014 (OR = 0.94; 95% CI, 0.87 to 1.02). In comparison, participants in 2020 (OR = 1.17; 95% CI, 1.08 to 1.27), 2017 (OR = 1.11; 95% CI, 1.02 to 1.21), and 2011 (OR = 1.43; 95% CI, 1.32 to 1.54) were more likely to be satisfied, while those surveyed in 2021 (OR = 0.66; 95% CI, 0.58 to 0.75) were significantly less likely to be satisfied. However, physicians in 2023 were more likely to experience burnout (OR = 1.82; 95% CI, 1.63 to 2.05) and less likely to be satisfied with WLI (OR = 0.59; 95% CI, 0.53 to 0.66) compared to other U.S. workers.
This study’s limitations included low response rates, but responders were similar to U.S. physicians in age and gender, and non-responder analysis revealed no significant bias in the reported outcomes.
This study highlights a decline in physician burnout in the U.S. from 2021 to 2023, which was similar to that of 2017. However, physicians still experience much more work-related stress than other U.S. workers. To solve these problems, further evidence-based action is required from healthcare organizations, governments, and payers.
Reference: Shanafelt TD, West CP, Sinsky C, et al. Changes in burnout and satisfaction with work–life integration in physicians and the general US working population between 2011 and 2023. Mayo Clin Proc. 2025;100(4):1-17. doi:10.1016/j.mayocp.2024.11.031
