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Is practicing medicine making US doctors sick?

John Murphy, MDLinx | March 14, 2019

Nearly three in four physicians report having at least one chronic health condition, and most of them (74%) say that their workload and/or stress contributes to it, according to a new MDLinx survey.

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stressed out doctor

Nearly 75% of physicians surveyed said that stress and/or added workload contribute to their own chronic health conditions.

For many physicians, both the physical and mental demands of the job instigate or exacerbate their health problems. “Inconsistent sleep patterns have worsened my hypertension, and stress from work has contributed to my depression/anxiety,” said one obstetrician/gynecologist.

“I think the cumulative effect of the stress and combination of night shifts and excessive workload contributed to my immune system dysfunctions of lupus and chronic leukemia,” said an emergency medicine physician.

For this survey, we gathered a list of common chronic conditions that have the highest impact on US adult health and quality of life, and asked physicians to name (anonymously) which conditions they have for comparison. In addition, we asked physicians to gauge where stress and added workload may have contributed to the development or worsening of their conditions. Here’s what we found out.

Stress and added workload

Of the 813 physicians who responded to this survey, 74.1% reported having one or more chronic health conditions while 25.9% said they had no chronic conditions. Overall, most physicians with chronic conditions agreed that work and/or stress negatively affected them:

  • 16% said that stress contributed to the development/worsening of one or more chronic conditions
  • 20% said that added workload contributed to the development/worsening of one or more chronic conditions
  • 38% said that both stress and added workload contributed to the development/worsening of one or more chronic conditions
  • 26% said that neither stress nor workload contributed to the development/worsening of one or more chronic conditions

“I am a prime example of another physician who has endured sustained levels of stress for too many years and unfortunately developed hypertension when I always had beautifully low BPs prior,” said an internal medicine physician. “I have also struggled with depression.”

“Every gastroenterologist in my group has had orthopedic surgery for work-related injury. Half suffer from migraine worsened by stress,” said a gastroenterologist with tendonitis, headache/migraine, high blood pressure, and high cholesterol.

Not all conditions are work-related, of course. One physician with Parkinson's disease said that, in most cases, the condition is idiopathic: “We do not know what causes or worsens it. Stress might have contributed to my illness, but I cannot say so for certain.”

Chronic conditions in physicians and nationwide

Compared with other adults in the United States, the physicians we surveyed reported relatively fewer chronic conditions overall. But for certain conditions (in blue), physicians’ rates were higher than the national average.

Chronic conditionPhysiciansUS adults
Hypertension 32.5% 31.9%
Hypercholesterolemia 21.3% 11.8%
Other 15.7% N/A
Clinical depression 15.6% 8.1%
Type 2 diabetes 12.3% 8.6%
Coronary heart disease 6.4% 11.7%
Anxiety 5.2% 3.1%
Back pain 2.5% 12.2%
Osteoarthritis 2.5% 9.7%
Crohn's disease/ulcerative colitis 2.4% 1.3%
Thyroid 2.4% N/A
Headache/migraine 2.1% 15.3%
Obesity 1.9% 39.8%
Gastroesophageal reflux disease 1.8% 20.0%
Asthma 1.6% 8.1%
Type 1 diabetes 1.5% 0.6%
Chronic obstructive pulmonary disease 1.3% 6.5%
Insomnia 1.3% 10.0%
Chronic fatigue 1.2% 0.3%
Atrial fibrillation 1.0% 2%–9%
Cancer 0.9% 9.4%

Notably, physicians report higher rates of hypertension, high cholesterol, clinical depression, type 1 and type 2 diabetes, anxiety, inflammatory bowel diseases, and fatigue than average US adults.

“Most US physicians suffer from hypertension, which can be made worse by stress,” said an oncologist.

“Chronic conditions also increase risk for depression,” noted an obstetrician/gynecologist with arthritis.

Said an endocrinologist with type 1 diabetes: “Stress clearly affects both colitis symptoms and the difficulty of controlling blood glucose in patients with diabetes. Both are common conditions.”

“I have no risk factors for diabetes, and yet I have developed prediabetes from what I know must be excess cortisol levels and increased blood glucose from the chronic stress, severe weekday sleep deprivation, etc,” said a public health physician. “I have also started an SSRI for the first time due to the work stress causing anxiety, self-doubt, etc.”

‘Worst thing ever’

Many physicians pointed the finger directly at one particular development that has made their lives worse: electronic health records (EHR).

“EHR is the number one reason physicians burn out quicker and increases anxiety across all of the fields of medicine,” an ophthalmologist lamented. “Worst thing ever added to the field of medicine and biggest cause of worsening physicians’ health!”

“Once I started having to use electronic medical records, I developed IBS on top of the dyspepsia and gastric ulcer history that I already had,” reported a psychologist also battling depression and high cholesterol.

Said a hospitalist: “Physicians are sitting in front of the computer spending 4 to 8 hours, most of the time without getting up, and…you feel so guilty once you get home because you haven't filled any of your responsibilities as a mother or a father.”

Physician, heal thyself?

You can’t take care of others unless you also take care of yourself—except there’s no time to take care of yourself, many physicians said.

“Long hours and added work burden prevent physicians from self-care needed to keep chronic conditions under control,” said a family medicine physician with arthritis. “I average 65 hours a week. There is little time for me to exercise or sleep.”

“I think physicians are held to standards which are not human, so we battle to be super human, to avoid litigation, keep employment, and pay off loans,” said a radiologist with clinical depression and inflammatory bowel disease. “We’ve spent countless years sacrificing for our profession only to continue placing ourselves last, particularly when it comes to doing the necessary things required to juggle our many responsibilities and for [our own] general health.”

“The extra workload and stress make it that much more difficult to make the lifestyle changes that we encourage our patients to make,” said a family medicine physician with clinical depression.

“I place my job first,” explained a dermatologist with high cholesterol, high blood pressure, and prediabetes. “The responsibilities are endless. I do not feel comfortable going to exercise when I have unfinished charts or have not responded to all prescription requests, calls, or notified all patients of results. And these just keep coming!”

A need for change

Notably, the pressure comes from both outside the profession as well as within. Several doctors mentioned that they feel compelled to hide or ignore their own conditions out of professional concerns.

“As a physician, I feel that any ailments I have are easily dismissed by my peers and staff,” said one respondent. “That is the stressful issue—that my ailments are less of a concern to others than ‘other patients.’”

Added another, “Physicians like me may be reluctant to disclose chronic health conditions out of concern that licensing bodies will penalize us unfairly.”

“We are not allowed to get help with mental illness or stress without suffering legal consequences [when] getting our medical license renewed; therefore, we suffer in silence,” said a cardiologist with heart disease, high cholesterol, and clinical depression. “This is archaic, and a national health policy needs to be changed regarding this topic.”

Unfortunately, there appears to be no end in sight to the increased stress and workload that physicians currently struggle with. But at the very least, get help or treatment for whatever chronic conditions you do have—before they get worse. “Prevention and early diagnosis would decrease morbidity,” one of your fellow physicians advised.

We hope that these findings can raise awareness about health conditions affecting physicians, some of which clearly contribute to job dissatisfaction, physician burnout, and possibly suicide.

Note: These results do not precisely represent the entire US physician population, but the trends signify meaningful implications.

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