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Roni Robbins | October 5, 2022
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Physician assistants (PAs) deal with their share of stressors, from having a name easily confused with doctors to needing medical oversight in many states to write prescriptions. So it comes as no surprise that PAs would have much to share about their battles with burnout and depression in Medscape's first Physician Assistant Burnout & Depression Report.
More than 1800 US physician assistants shared their thoughts about their level of burnout and depression, what leads to their difficulties, and how they cope.
"This problem began long before the pandemic, and it will continue after," said Jennifer Orozco, president of the American Academy of PAs (AAPA).
The professional society understands that "burnout is a significant concern, which is part of the reason AAPA set up a taskforce on burnout in 2019," Orozco says, adding that the organization supports and encourages PAs "to focus on their own well-being."
(Note: Some totals in this presentation do not equal 100% because of rounding.)
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
"Clearly, the pandemic magnified issues already present in medicine," says Jonathan Baird, PA-C, DMSc, assistant professor of the PA program at Rocky Mountain University of Health Professions in Provo, Utah, and part-time practicing PA for the nearby United Way of Utah County Volunteer Care Clinic.
Well over half of total PA respondents report feelings of burnout, whereas one third of PAs are depressed.
Gender also comes into play. Female PAs (65%) are more likely than male PAs (54%) to be burned out and are more often depressed than their male peers (33% vs 27%).
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
"Burnout is a more serious problem than ever for PAs," says Michael Sharma, PA-C, an emergency medicine and urgent care PA. "I hear about a lot of PAs having to do more with less these days, more work tasks, less assistance or benefits."
Some PAs have reported that tension between physicians and PAs also adds to the latter's stress, Sharma said.
On a scale of 1 to 7 (most severe), part-timers (18%) are more likely to rate their burnout as a 7 compared with their full-time counterparts (10%).
PAs aged 45 years or older are also more likely to rate their burnout as a 7 compared with PAs younger than 45 years (16% vs 9%).
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
PA burnout has been highest in the past 2 years, coinciding with the global pandemic.
"Burnout hits us all from time to time," one respondent said. "It kind of ebbs and flows, depending on patient population, support staff, or lack thereof. It's important to recognize it and figure out how to regroup."
Another respondent offered, "I think burnout can happen quickly in our field. I think we work hard to prove ourselves as knowledgeable and contributing members to the team. That burnout and workload can get too heavy, very quick."
Sharma offers his own perspective. "Burnout is more likely to occur when a person feels like they have too much work on their plate and not enough control over their situation. PAs may be uniquely vulnerable to burnout compared with other clinicians because they are still considered dependent practitioners in most states."
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Double the PAs feel more burned out now than during months of COVID quarantine. Of PAs who said they were burned out, nearly 6 in 10 said they felt so now more than the initial months of the pandemic.
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Heavy administrative burdens, interpersonal toxicity, and excessive workloads are burnout contributors cited by Heidi Posey, PA-C, cofounder of the nonprofit The Burn Clinic, which specializes in burnout for healthcare providers.
Based on respondents who say lack of respect from administrators/employers, colleagues, or staff contributes most to their burnout, 63% cited administrators/management and 22% claimed physicians as the source.
In addition, 15% cited stress from treating patients with COVID; 12% cited lack of control/autonomy; 7% cited government regulations; and 10% offered other reasons.
"In my current role, it is harder for me to provide preventive medicine to patients," noted one respondent. "This leaves me feeling less fulfilled and less helpful to patients to make a long-term difference with their health."
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
More than 4 in 10 PAs experiencing burnout do not feel that their personality type is a contributing factor.
Male PAs are less likely than female PAs to believe that their personality type is a contributing factor to burnout (55% vs 42%).
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
About 1 in 10 PAs feel they deal with their stress better than their peers; nearly double that amount feel they do a worse job handling the pressure.
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Baird answers in the affirmative. "Interpersonal conflict ensues due to unmet expectations and needs," he says. "The problems originating in the workplace come home and create problems away from the workplace, affecting workplace performance and creating a vicious cycle."
Brown agrees. "We are humans, and as much as we are able to compartmentalize some things, it is inevitable for it to start showing in our work relationships, our relationships with ourselves, and with our spouse and children."
Full-time PAs more often report burnout negatively affecting their relationships than do part-time PAs (68% vs 59%).
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
"It is not enough to only study burnout," says David J. Bunnell, MSHS, PA-C. "Organizations must understand what contributes to healthy workplaces that contribute to wellness and joy."
Brown shares similar sentiments. "We need employers who support boundaries with work/life, provide flexibility, reasonable workloads, and support staff to create improved efficiency. We need programs that actively implement practical changes to reduce our stress levels … We need administrators to listen to what we need instead of doing what they think we need."
Increased compensation would also help, one respondent said. "Recent changes in autonomy, with (hopefully) pay structures to follow suit, will help show we are just as valuable and should be paid as such."
Among respondents, 12% cited fewer government regulations; 7% working at the top of their licensure; 7% clearer role expectations from their employer; and 5% not having to treat patients with COVID. Smaller percentages cited more or easier access to PPE, and still others offered alternate ideas.
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Part-timers more often exercise in response to burnout than do full-timers (58% vs 48%). Meanwhile, full-time PAs more often cited sleep compared with their part-time peers (54% vs 44%).
And PAs younger than 45 are more likely than PAs aged 45 or older to respond to burnout with sleep (57% vs 45%), talking with family members/close friends (50% vs 39%), eating junk food (43% vs 36%), or binge-eating (24% vs 18%).
Respondents also included 22% who said they binge-eat. Some PAs listed using prescription drugs, using cannabis products, or smoking cigarettes/using nicotine products; and some chose "none of the above" or "other" as responses.
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
"PAs handling work well typically have a healthy identity outside of medicine," Baird says. "They have hobbies they enjoy or other organizations and causes they assist in which bring them joy … In short, they are working to live, not living to work."
Respondents also included the 12% who listed other remedies and the 17% who listed none of the above options.
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
A minority of PAs have used outside programs or coaches to reduce burnout.
Full-time PAs are more willing than part-time PAs to consider using services with programs to reduce burnout (63% vs 53%).
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Of PAs who are depressed, 39% said they have immediate family members who are or have been clinically depressed, meaning severe depression lasting some time, not caused by a normal brief event; 24% have family member who are colloquially depressed, meaning feeling down, blue, or sad; 27% said that they didn't have any family who fell into these categories; and 12% were unsure.
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Male PAs are more likely than female PAs to attribute depression to finances (40% vs 28%).
Some respondents said that depression can arise from stress, isolation, and being irritable or tired, with these factors even leading to divorce: "As much as you try to divide work and home life, if you're overly stressed it will trickle into your home life," one PA said.
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Over half of PAs have experienced depression at least once or more often prior to becoming a healthcare professional.
PAs younger than 45 are more likely to have experienced depression at least once or more often prior to becoming a healthcare professional compared with their peers age 45 or older (58% vs 47%).
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Owing to depression, 4 in 10 PAs express their frustration in front of colleagues and similarly are easily exasperated with colleagues.
Half of part-time PAs (49%) do not let their depression affect their interaction with patients or colleagues, compared with 29% of full-time PAs. And full-time PAs are more likely than part-time PAs to get easily exasperated (39% vs 23%) and express frustrations (44% vs 25%) with colleagues.
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
The majority of PAs have not felt suicidal or attempted suicide.
One respondent said, "I unfortunately lost a colleague and former classmate from PA school to suicide in 2021."
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Almost half of PAs who have ever felt suicidal or attempted suicide have mentioned thoughts of suicide to a therapist.
Female PAs are more likely than male PAs to mention thoughts of suicide to a friend or colleague (39% vs 20%).
Meanwhile, the vast majority of all PAs (93%) surveyed have never had a colleague or peer inform them of their suicidal thoughts.
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
More than half of PAs believe they can deal with their issues on their own and fear repercussions for acknowledging their concerns. For PAs, the stigma of seeking mental health support mirrors concerns documented by other healthcare professionals.
In addition to more commonly cited reasons to avoid seeking help, 21% of PA respondents listed other reasons why they don't seek assistance.
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Brown doesn't think many PAs seek help for burnout or depression.
"First, it's hard to acknowledge when this is happening. We are inherently successful people, and having burnout and depression can feel like failure, even though it is in no way a reflection of the person themselves," she says.
In addition, job flexibility offers "options to find another position or specialty. But change is hard, so we often stick to what we know, even if it is a toxic work environment."
Sharma points to the stigma of asking for help. "I think some PAs have a not completely baseless concern that any seeking of behavioral health care could lead to state medical board or hireability issues. We've seen it happen to physician colleagues."
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
A minority of PAs report their current employer has a program to reduce stress or burnout.
One respondent offered a grim perspective: "Employees need to feel safe to utilize burnout prevention measures provided by employers. Discussing among colleagues, these current services are perceived as either a trap or nothing ever comes of it when we voice concern. Most people I've talked to only found relief from burnout by switching jobs completely."
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
Part-time PAs are more likely than full-time PAs to rely on exercise (74% vs 66%) and activities/hobbies they enjoy (77% vs 71%) to keep up happiness and mental health.
Female PAs are more likely than male PAs to spend time with family or friends (78% vs 70%). And PAs younger than 45 years are more likely than those aged 45 or older to spend time with family or friends (80% vs 68%).
Sometimes just a different practice setting is all it takes to maintain happiness and mental health, as one respondent reported. "I live in a very small community where the medical providers are appreciated by the general population, which is very helpful in preventing burnout for me."
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
"Most early to mid-career PAs can't afford to leave the profession due to student loan debt," Sharma says. "The debt issue is compounded by the current economy's impact on cost of living, job availability, and income. I do feel like I see more people seeking nonclinical positions, away from the bedside. There are fewer of these positions for PAs out there than for physicians or nurses, though."
One respondent attributed his mindset to the pandemic. "COVID has made me rethink staying in medicine as I have watched others in careers where they have helped others and gained financially from these efforts with less stress."
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
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Medscape Physician Assistant Burnout Report 2022
Roni Robbins | October 5, 2022 | Contributor Information
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