We have a big problem in this country. A recent poll found that half of U.S. physicians are still burned out. When Medscape surveyed 9,000 physicians across 29 specialties this year, they found that 49% of physicians report being burned out, and 20% report they are depressed. Physicians in front-line specialties who deliver primary care continue to be the most often affected.
A higher prevalence of female doctors (56%) report being burned out compared to male physicians (44%). Most burned-out physicians feel that their burnout had a moderate to severe effect on their lives and negatively influenced their relationships. Women physicians cite challenges in work-life integration as a large factor, as they predominantly handle childcare and issues with aging parents.
It is well known that most physicians’ burnout is due to an excessive burden of administrative tasks, a perceived lack of respect from administration and managers, excessive work hours, and unmanageable work schedules. Insufficient compensation and lack of autonomy are also factors.
Sadly, very few physicians are seeking professional mental health therapy for their burnout or depression – only 11% in this latest report. Some physicians reported having insufficient time to get help. Forty percent of them fear disclosure to the medical board and expressed concerns about therapy showing up on their insurance records. Many do not want their colleagues to know or think of them as “weak.” Unfortunately, only 8% have used the services of companies, individuals, and coaches who offer programs to reduce burnout (though 46% would consider doing this).
The rates of burnout among nurses are much like those among physicians. A recent poll found that 56% of working nurses in the U.S. are burned out. This number is higher among younger nurses with fewer than 20 years of experience. Despite this high prevalence of burnout, only 30% of burned-out nurses are getting any help with this. The American Nurses Foundation and McKinsey surveyed more than 7,000 nurses in April and May of 2023.
Approximately two-thirds of surveyed nurses indicated they were not currently receiving mental health support, and 56% believe there is a stigma attached to mental health challenges. Twenty-nine percent indicated that lack of time prevented them from seeking mental health care. Twenty-three percent indicated that “they should be able to handle their own mental health,” and 10% cited cost or a lack of financial resources as a reason for not seeking care.
The nurses who indicated they were likely to leave their jobs reported that they “were not feeling valued” by their organizations. They also reported “insufficient staffing” and “inadequate compensation” as factors influencing their decisions. Over 40% reported poor control over their workloads and hectic and intense day-to-day work.
We know that burnout has several adverse, long-term health effects, such as chronic health problems like cardiovascular disease, gastrointestinal issues, and compromised immune function. Burnout is a predictor of mental health problems like anxiety and depression. In physicians, burnout increases the risk of suicide. These health conditions incur not only personal costs but also societal costs because they decrease productivity, increase rates of absenteeism, decrease employee retention, reduce job satisfaction, and shorten career longevity. Our serious national problem with burnout among health care providers is manifested more often among working women, most of whom are mothers.
Based on my personal experience, I believe there is an important role for psychotherapy in working mothers’ burnout. However, there is clearly a stigma against using mental health care services to address this problem. I have written about my episode of working mother burnout while working an inhumane schedule for a boss I did not like and, in my off hours, trying to be a decent mother to three small children. I wrote about my struggles not only as a personal example of burnout but also as an encouragement for other women to self-identify and secure the help they need.
When I was severely burned out at age 42, psychotherapy provided a space for me to discuss and process all the stressors in my life. This contributed to a reduction in my overall stress levels. My therapist taught me coping strategies to manage my anxiety and stress and provided practical tools that I could apply in both my personal and professional lives.
In the past, when I reapplied for state licensure and hospital credentials, I was asked questions about my mental health: “Have you been treated for any mental health or substance use disorder?” and “Are you taking any medication or treatment that will affect your ability to treat patients or practice medicine?” I answered no because I felt that it was none of their business!
Thankfully, the landscape is changing for medical licensure and hospital credentialing. Since September 12, 2023, physicians in 25 states are no longer being asked these broad mental health questions when they apply for a medical license. The Lorna Breen Foundation is working with state medical boards and hospitals to remove stigmatizing mental health questions from licensing and credentialing applications. While state medical boards have made tremendous strides to support physicians, more action is needed to drive changes for hospitals and health systems. Additionally, these changes must be made in nursing licensure boards, specialty licensure boards, and insurance/malpractice applications.
We need to destigmatize psychotherapy for working women, physicians, and nurses and change the conversation around professional therapy. Counseling offers a supportive environment where working mothers can express their feelings without judgment. This can be particularly valuable for those who feel isolated or overwhelmed.
For me, a mother who constantly juggled high-stress work and parenting, therapy provided guidance and support in navigating the challenges of raising children while maintaining my career. Counseling helped me thrive both at work and at home. Like many other working mothers, I struggled with setting boundaries between work and my personal life. I had never learned to say no. Therapy helped me establish healthy boundaries and prioritize my own self-care.
I became a more mindful working mother and physician with psychotherapy. Over the long term, therapy enhanced my self-esteem by addressing my anxiety and challenging my negative thought patterns (like “you should be doing this” or “you are not a good enough mother”). The therapeutic process contributed to my improved self-esteem and self-confidence.
Psychotherapy also equipped me with skills to navigate conflicts both at work and at home, fostering healthier relationships in both situations. The benefits of psychotherapy will vary from person to person, and the effectiveness will depend on your commitment to the process. Choosing the right therapist and therapeutic approach that aligns with your needs is crucial for a positive outcome.
Susan Landers is a retired neonatologist with 34 years of experience and has practiced both academic and private medicine. She can be reached on her website, Instagram @drsusanlanders, Facebook, and Substack.
She is an expert in burnout, breastfeeding medicine, and human donor milk banking. Her memoir, So Many Babies, is a realistic look into life inside the NICU and recounts many of her travails as a professional working mother. Her new eBook is Defeating Burnout: A Guide for Working Mothers. She publishes a popular newsletter called MomsMatter on Substack and a blog for parents on her website.
