About 42 percent of U.S. physicians are burned out, while almost 50 percent are willing to take a pay cut if it means better hours and more time with family and friends.

Those are the findings made by Medscape in its National Physician & Suicide Report 2020: The Generational Divide. The report found feelings of burnout among almost half of doctors born in the Generation X era (ages 40-54), as well as 39 percent of baby boomers (55-73) and 38 percent of millennials (25-39). Most of Generation X attributes burnout mainly to the number of bureaucratic tasks they face, too many hours at work and a lack of respect from bosses and colleagues.

“Mid-career is typically the time of highest burnout, which is where Gen Xers are in their career trajectories,” said Dr. Carol Bernstein, vice chair for faculty development and well-being at Montefiore Medical Center/Albert Einstein College of Medicine, in the survey. “In addition, I suspect that group is juggling multiple jobs outside of work, including caring for children as well as elderly parents, and working as well as planning for retirement. Role strain and transition periods also increase stress.”

Of all physicians, 55 percent blamed too many administrative tasks such as charting and paperwork followed by too many hours working as the main causes of burnout, which is described in the report as ‘long-term, unresolved, job-related stress leading to exhaustion, cynicism, detachment from job responsibilities, and lacking a sense of personal accomplishments.

While feelings of burnout declined from 46 percent in 2015 to 42 percent in 2019, the condition is still prevalent, with the highest rates seen among urologists (54 percent), neurologists (50 percent), and nephrologists (49 percent). Radiology tied with family medicine, Ob/Gyn, and diabetes and endocrinology for fourth place, followed by infectious diseases in fifth. Lowest rates were found among orthopedists (34 percent), ophthalmologists (30 percent), and public health and preventative medicine specialists (29 percent).

Like Generation Xers, millennials pointed to administrative tasks, long work hours and lack of respect from employers, colleagues and staff as the main causes of burnout. Baby boomers also listed administrative tasks and work hours, along with increased computerization of EHRs.

Close to 40 percent of all respondents said burnout made them prone to easily become exasperated with patients and nearly 20 percent said they expressed frustration in front of their patients. Almost three-quarters across all generations reported an impact on their personal relationships, and nearly 20 percent reported feeling depressed. Close to a quarter admitted to having had suicidal thoughts, but only about one percent actually attempted to kill themselves.

Despite these negatives, over 60 percent of millennials reported being happy with their worklife, followed by 59 percent of boomers and 56 percent of Generation X. Forty-nine percent of all respondents, however, were willing to trade $20,000 of their paycheck for more free time with family and friends, and about one-third said they would take a pay cut of $50,000 if it meant better hours and more balance between work and their personal lives.

“Expectations of what a career as a physician is in the 2020s is changing,” said Halee Fischer-Wright, CEO of the Medical Group Management Association, in the report. “Physicians recognize that seeing a smaller number of patients may give them more time with patients and the ability to practice medicine at the height of their license, reducing non-clinical hours and enhancing personal satisfaction, which ultimately may decrease burnout and extend their career life.”

A higher percentage of women were willing to take a pay cut than men. Female physicians were also 25 percent more likely to report burnout than their male colleagues across all specialties. Only a little more than 25 percent indicated that their workplace offered stress reduction programs, while half said theirs did not. Despite their being access to such programs, almost two-thirds among all generations indicated that they were handling their burnout and depression alone and had never sought help.

“Although there is increasing pressure for organizations and hospitals to provide wellness programs for physicians, 42 percent of respondents overall said they would probably not use them,” said Leslie Kane, senior director of Medscape Business of Medicine. “Many physicians don’t believe that such programs are helpful; others don’t want their colleagues at their workplace to know they’re feeling burned out.”

More than 15,000 physicians in 29 different disciplines took part in the survey.