Are US doctors actually happy?

Doctor happiness has taken a plunge. Reports of physician burnout and dissatisfaction are not new, but the COVID-19 pandemic appears to have left many doctors in a much worse mental state.

That’s according to Medscape’s recently released Physician Lifestyle & Happiness Report 2021, which includes responses from more than 12,000 physicians across 29 specialties.  

Before COVID-19 turned everyday life upside down, 82% of doctors reported they were largely happy outside of work, according to last year’s survey. In the 2021 report, only 58% can say the same. And happiness at work took a sharp dip during the pandemic, too—69% were happy at work last year compared with 49% since the pandemic began, according to another Medscape survey, the 2021 Physician Burnout & Suicide Report.

Here’s why doctors report being less happy, what they’re doing about their mental health and well-being, and how they feel about the future.

Viral unhappiness

The pandemic has affected doctors’ outlooks and moods, and recent research is uncovering the contributing factors.

A study published in Psychological Reports last October, collected survey data on more than 200 healthcare workers, and found that common mental impacts of COVID-19 include anxiety, panic, depression, anger, confusion, ambivalence, and financial stress. The study cited a range of other research, which indicated that these feelings are linked to heavier workloads and fear of catching the coronavirus themselves while treating infected patients. 

Another study published in The Lancet, which focused on the experiences of healthcare workers during the pandemic, corroborates these findings. Researchers found that healthcare workers faced new challenges including “working in a totally new context, exhaustion due to heavy workloads and protective gear, the fear of becoming infected and infecting others, feeling powerless to handle patients' conditions, and managing relationships in this stressful situation.”

These studies provide context for the Medscape survey findings, which illuminate the impacts of this added stress.

Physicians’ families feel the effects, too. The survey found that 73% of women and 54% of men feel at least somewhat conflicted as parents, due to increased workloads and anxiety over the virus. More than a fifth of female physicians reported feeling very conflicted about parenting during the pandemic.

But many physicians don’t appear to have time to focus on how they feel, let alone how their new work environments affect their loved ones. Only 5% of respondents reported always having enough time to focus on their mental health and wellness, with a little under half saying they “sometimes” find enough time. As with parenting, the response to this question revealed a gender gap, with 39% of male physicians saying they always or mostly had enough time to focus on mental health, compared to 28% of female physicians.

Busy schedules can inhibit activities that would improve physical and mental health. For example, when it comes to exercise, 20% of respondents said they work out once a week or less, and 10% reported that they don’t exercise. This suggests that many doctors aren’t hitting the World Health Organization’s exercise recommendations, published last year, to aim for 150 minutes of moderate exercise or 75 minutes of vigorous exercise weekly. In addition, roughly half of physicians responding to Medscape’s survey said they’re trying to lose weight.

Among the most significant findings of the survey were the responses to a question on whether physicians would be willing to take a pay cut to have a better work-life balance. Forty-seven percent said yes, with 32% saying they would be willing to be paid $10,000-$20,000 less and another third saying they would consider taking a $20,000-$50,000 pay cut.

Coping strategies

The findings of Medscape’s survey weren’t all doom and gloom and indicated that many physicians are addressing their mental states.

When it comes to maintaining mental health outside of work, two-thirds of physicians reported engaging in daily hobbies, like reading, cooking, or gardening, and roughly the same percentage said they spend time with family or friends to improve mental wellness. Perhaps a more worrying statistic is that only 7% reported using therapy to address their unhappiness. Additionally, fewer than half of respondents reported eating healthily or sleeping sufficiently.

Despite the pandemic straining doctors’ relationships outside of work, 85% of the respondents to Medscape’s survey were married or living with a partner, and 85% of those individuals reported their relationship as being in an either “good” or “very good” state. The survey found that those in the happiest marriages tended to work in pulmonary medicine, dermatology, ophthalmology, and urology, while those in the least happy marriages work in critical care, psychiatry, infectious diseases, and rheumatology.

Many doctors are finding time to take vacations. According to the survey, 43% currently take 3-4 weeks off a year and 30% take 1-2 weeks off.

The future

Of course, COVID-19 hasn’t gone away. While vaccine rollouts and dropping case numbers have left 24% of physicians not feeling anxious about the coming months, three-quarters remain at least slightly anxious. The fields in which doctors remain most anxious include rheumatology, allergy and immunology, pediatrics, infectious diseases, and dermatology.

Doctors’ future happiness may depend on how the pandemic evolves this year and whether vaccines and continuing protective measures can quash new variants.