Doctors Worldwide Are Burned Out, Spelling Trouble For Global Workforce, New Study Shows

Shot of a young female nurse looking stressed out while standing at a window in a hospital

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Amidst healthcare’s Great Resignation, recent research has shown high levels of burnout among nurses—and widespread concern about resulting harms to patient care. But new research released today from the Commonwealth Fund shows these concerns are not just rampant among nurses, but doctors, too.

In a global survey of 9,500 primary care physicians (PCPs) in 10 high-income countries, more than half—including 65% of PCPs in the United States—said their workload has increased since before the pandemic.

In the face of increased workloads, PCPs in nearly all 10 countries reported significant levels of stress, emotional distress, and burnout. These strains were especially common among physicians under age 55.

“The survey findings confirm what many fear to be true: The pandemic is taking an alarming toll on the wellbeing of our primary care workforce, both here in the U.S. and around the world,” said Commonwealth Fund president David Blumenthal in a briefing.

“Primary care is the backbone of a high-performing healthcare system, and it is vital to the wellbeing of communities across America and around the world,” he said.

PCPs in the Netherlands and Switzerland were generally among the least likely to report these negative experiences, while the United Kingdom, New Zealand, and Canada tended to top the lists.

Blumenthal said he was surprised that the United States didn’t perform worse than it did.

“In so many respects, our primary care system is less well developed [and] less well-resourced than other countries,” he said.

Munira Gunja, senior researcher in the Commonwealth Fund’s International Program in Health Policy and one of the study’s authors, said in the briefing that she was surprised to find that many of the issues identified in the survey are global.

“In so many instances, we find that the U.S. healthcare system is trailing behind other systems,” she said. “But in this study, we find that all healthcare systems really need to figure out how to prioritize the wellbeing of the primary care workforce if we hope to have a sustainable, high-functioning, high-performing healthcare system.”

The generational divide

Among U.S. PCPs, more than half reported that their job is very or extremely stressful. Younger physicians reported stress at higher levels than older ones, with 63% of PCPs under 55 saying their job is stressful, compared to 54% of PCPs over 55.

That pattern held among PCPs in all the countries in the survey. PCPs in New Zealand, Germany, and the United Kingdom were even more likely to report high levels of stress. Three-quarters of PCPs under age 55 in the United Kingdom said their job is extremely or very stressful. France had the smallest differential between younger and older PCPs’ experience (48% of younger and 46% of older physicians reported high levels of stress).

PCPs aren’t just facing increased stress; they’re experiencing emotional distress, such as anxiety, sadness, anger, or hopelessness. Across all countries, at least two in five PCPs under age 55 reported experiencing these feelings. In the United States, this figure was 61% (compared with 45% of PCPs over age 55).

Younger PCPs were also more likely than older ones to report burnout. In the United States, 50% of PCPs under 55 said they feel burned out. Just Canada and New Zealand reported higher rates, with 53% and 57%, respectively, of younger PCPs in those countries reporting burnout.

Among PCPs who experienced emotional distress, the percentage who reported seeking mental health services was concerningly low. Just 16% of younger PCPs and 6% of older ones in the United States had sought professional help for their mental health needs. German PCPs reported the lowest rates of seeking professional help (6% of both age groups) while New Zealand had the highest rates (23% of younger and 11% of older PCPs sought professional help).

The toll of stress, distress, and burnout

Not only are physicians suffering from increased workload, stress, and burnout; patients, too, are receiving lower quality of care, physicians said.

Among PCPs who reported experiencing stress, emotional distress, or burnout, substantial portions in many countries said the quality of medical care they were able to provide worsened somewhat or a lot compared to pre-pandemic times. In the United States, that figure was 28%. In Sweden and the United Kingdom, more than half of PCPs who faced those challenges reported negative impacts on the quality of care they provided.

Though older physicians were less likely than their younger colleagues to report negative emotional impacts during the pandemic, they were more likely to say they plan to stop seeing patients within one to three years. In the United States, that figure was 45%. In several countries—including Canada, France, New Zealand, and the United Kingdom—more than half the PCPs older than 55 plan to stop seeing patients in the near future. In the United Kingdom, it was two-thirds.

Younger PCPs were less likely to report that they intend to opt out of providing patient care, but still 14% of U.S. PCPs under 55 said they intend to stop seeing patients within one to three years. In the United Kingdom, it was one in five.

These findings could spell trouble for health systems worldwide, according to Blumenthal.

“For decades, we’ve known that the U.S. and many other countries have faced a shortage of primary care physicians,” he said. “And these latest findings suggest that without interventions, this shortage may soon reach record levels. Policy makers and health system leaders can take steps now to address this growing workforce crisis by investing more in their primary care systems and ensuring that doctors are practicing in healthy work environments that are not harmful to their physical and mental health.”

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