U.S. leads in primary care physician burnout among 10 development nations, study says

The United States is the world leader for burnout among primary care physicians (PCPs) in 10 developed nations, according to new findings from the Commonwealth Fund.

“The Causes and Impacts of Burnout Among Primary Care Physicians in 10 Countries” listed results of its International Health Policy Survey of Primary Care Physicians, a poll this year of 10,895 PCPs in the United States, Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland and the United Kingdom.

Generally, the problem is paperwork, not patients.

“Across all countries, most physicians are dissatisfied with the amount of time they spend on administrative tasks, with more than two of five primary care physicians in the U.S. reporting it as the primary reason for their burnout,” the study said.

In the United States, 43% of doctors said they feel burned out. New Zealand and Canada tied for second place at 38%; the lowest was the Netherlands, where 11% of physicians reported feelings of workplace burnout.

Among PCPs reporting burnout, Switzerland was the worst offender for administrative burden. There, 65% of physicians said the administrative burden was problematic, followed by Germany at 50% and Canada at 45%. The United States landed fourth with 44% of physicians reporting burnout due to crushing administrative pressure.

The survey asked PCPs feeling burnout if there were “somewhat” or “very” dissatisfied with the time they spend on administrative work. No nation landed below 80% — Australia was lowest at 83%, Germany and New Zealand tied at 92%, and the United States was at 85%.

Compared with administrative burdens, PCPs with job burnout rated working with patients was rated as a much lower cause of burnout. Sweden had the most at 48%. Australia, New Zealand, the United Kingdom, Germany and Switzerland all topped the United States and Canada, which tied at 14%. Data could not be showed for France and the Netherlands due to sample size limitations.

As for time per patient, the United Kingdom led with 86% of PCPs with burnout stating they were “very” or “somewhat” dissatisfied with the amount of time together. Canada was lowest at 37%, while the United States was at 54%. Germany was at 60%, and Germany led for 63% of PCPs with burnout stating they spend less an average of less than 15 minutes with patients per routine visit, and 78% said they see on average more than 150 patients during a typical work week.

Feelings of value also contribute to burnout, or may counteract it. In Australia, 36% of PCPs burnout said they felt their work was not adequately valued, while 31% said in the United Kingdom. The other nations were at 20% or less, with 17% of United States physicians with burnout saying feeling undervalued contributed.

PCPs with burnout “are more likely to experience emotional distress and more likely to say they intend to leave the field in the near future,” the report said.

“Administrative burden, workload, and moral distress all contribute to heightened feelings of exhaustion and burnout,” the report said. “Additionally, repeated moral distress, heightened by the COVID-19 pandemic, can lead to demoralization, a close cousin to physician burnout. Physicians who feel overwhelmed by bureaucracy and persistent inequities may also choose to leave the profession.”