Is Healthcare Consolidation Fueling the Physician Burnout Crisis?

According to a survey of more than 1,700 physicians, residents, and medical students, burnout is tied to multiple factors, including mental health stigma in the medical field as well as how private equity acquisitions are changing healthcare.

The Physicians Foundation’s annual Survey of America’s Current and Future Physicians revealed this year that burnout is rampant in the workforce; six in 10 physicians and residents and seven in 10 medical students reported burnout. Before the pandemic, that statistic was four in 10 for physicians.

“The bottom line is, we still have a huge problem with physician burnout in our healthcare workforce,” Gary Price, MD, president of The Physicians Foundation, told MedPage Today.

Burnout contributes to devastatingly high levels of suicidality, with more than half of physicians reporting they knew of a colleague that considered, attempted, or died by suicide, the report found. Respondents overwhelmingly said that there is stigma around mental health and seeking care within the medical profession, in part tied to related questions asked in medical licensure, credentialing, and insurance applications.

In fact, 71% of residents and 59% of medical students said that changing or removing questions that stigmatize accessing behavioral healthcare from the licensure process would be helpful. Still, medical students are far more likely to seek mental health care (49%) than residents (33%) or physicians (18%), indicating a shift in the attitudes and behaviors of future physicians.

Respondents also said changes in the healthcare environment fueled by acquisitions, mergers, and private equity are contributing to the burnout crisis. Among those who have experienced mergers or acquisitions, many said that it negatively impacted their job satisfaction (50%), the quality of patient care (36%), patient healthcare costs (30%), as well as independent medical judgement (35%). Plus, most respondents (seven in 10 physicians and medical students and six in 10 residents) said that consolidation is having a negative impact on patient access to high-quality and cost-efficient care.

“It appears that consolidation has changed the environment physicians find themselves caring for patients in a lot,” Price said. “This new paradigm of care has raised some new issues with burnout, but also some fundamental, real issues that we need to take a hard look at, when the economics of healthcare institutions might potentially come in conflict with the needs and best interests of the patients they serve.”

Price also noted that physician burnout is further fueled by losing autonomy when private equity steps in, as they face barriers operating in patients’ best interest and generally don’t have “complete control over the outcomes that they’re held responsible for.”

As a whole, physicians said that safeguards for private equity involvement and consolidation in healthcare are needed to protect their autonomy. They also said guardrails that maintain patient standards, increase transparency, and look at long-term impacts are helpful. As of now, very few physicians were involved in the decision-making process in a merger.

The survey took place from June 17 through July 16, 2024, and had 1,723 respondents. Of the 1,020 physicians who responded, about 40% were primary care and the rest were specialists. Nearly three-quarters were employed (vs being in independent practice), about half were 45 or younger, and nearly two-thirds were male. In terms of race and ethnicity, 57% of physician respondents were white, 35% were non-white, 18% were Asian, and 9% were Hispanic.

About half of both residents and medical students were male, and they were more diverse. Among 353 residents, 53% were white, 42% were non-white, 24% were Asian, and 12% were Hispanic. For the 350 medical students who responded, 47% were white, 46% were non-white, 24% were Asian, and 11% were Hispanic.

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