Neurology and therapy · 2025
Ожог среди врачей, которые лечат пациентов с множественным склерозом в США: подкаст.
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Rensel Mary, Sullivan Amy B
Аннотация
Физический извержение, усиливающийся кризис в системе здравоохранения Соединенных Штатов Америки (США), характеризуется долгосрочным стрессом, связанным с работой, который проявляется в истощении энергии, чувстве повышенной умственной дистанции или цинизме к работе и снижении профессиональной эффективности. В частности, неврологи относятся к числу тех, у кого наиболее высокие показатели вымирания и наименьший уровень удовлетворенности сбалансированностью между работой и личной жизнью. В то же время данные об истощении среди врачей, которые лечат пациентов с множественным склерозом (МС), остаются ограниченными. В рамках этого подкаста мы обсуждаем результаты проведенного в США количественного обследования с участием 136 врачей, которые лечат пациентов с синдромом MS (определяемся как прописывающие ≥3 MS-модифицированные методы лечения в течение 12-месячного периода). В ходе обследования были проанализированы распространенность вымирания среди этой группы населения и связанные с этим факторы риска. Она включала в себя 20 вопросов, включая кадастр мини-Z, 3.0, демографические данные, профессиональную информацию и подробную информацию об условиях труда и поддержке занятости. Полученные результаты свидетельствуют о значительном распространении (примерно 50%) истощения и стресса, связанного с работой. К числу основных факторов, обусловливающих стресс на рабочем месте, относятся бремя ведения электронной медицинской документации и продолжительный рабочий день. Несмотря на высокий уровень удовлетворенности работой, о котором сообщили участники, относительно того, что почти 50% этих врачей рассматривали вопрос о смене своей области из-за истощения или связанных с этим проблем. Мы также изучаем воздействие истощения на уход за пациентами и управление ими, предлагая рекомендации по решению этих проблем.
Оригинал публикации
Burnout Among Physicians Treating Patients with Multiple Sclerosis in the United States: A Podcast.
Physician burnout, a growing crisis in the healthcare system of the United States of America (USA), is characterized by long-term job-related stress that manifests as energy depletion, feelings of increased mental distance from or cynicism toward one's job, and reduced professional efficacy. Notably, neurologists rank among those with the highest rates of burnout and the lowest levels of satisfaction with work-life balance. However, data on burnout among physicians treating patients with multiple sclerosis (MS) remain limited. In this podcast, we discuss the findings of a USA-based quantitative survey involving 136 physicians who treat patients with MS (defined as having prescribed ≥ 3 MS disease-modifying therapies over a 12-month period). The survey investigated the prevalence of burnout within this population and its associated risk factors. It included 20 questions, including the Mini Z inventory v3.0, demographic data, professional information, and details about work environment and job support. The results revealed a significant prevalence (approximately 50%) of burnout and job-related stress. Key contributors to job stress included the burden of maintaining electronic medical records and long working hours. Despite high levels of work satisfaction reported by participants, it is concerning that nearly 50% of these physicians had considered switching their field due to burnout or related issues. We also explore the impact of burnout on patient care and management, offering recommendations to address these challenges.
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Key Summary Points
This survey provides key insights into the high prevalence of burnout and job stress among physicians treating patients with multiple sclerosis (MS) in the United States of America. The burnout rate among such physicians is alarmingly high, with 50% of respondents experiencing burnout or signs of burnout. Electronic medical record-related stress and extensive working hours were found to be significant contributors to burnout. Despite high job satisfaction, approximately 50% of the surveyed physicians had considered leaving the field because of burnout and related issues. This study may serve as a basis for future research aimed at improving the quality of life of physicians treating patients with MS, thereby reducing attrition and enhancing patient care.
Digital Features
This article is published with digital features, including podcast audio and an infographic, to facilitate understanding of the article. To view digital features for this article, go to 10.6084/m9.figshare.28653302.
Alternatively, the podcast can be found by searching "Adis Journal Podcast" with your preferred podcast platform.
Introduction
MR: Hello, and welcome to the “ Burnout Among Physicians Treating Patients with Multiple Sclerosis in the United States of America” podcast from the Adis journal Neurology and Therapy . I am Dr. Mary Rensel, Director of Wellness at the Department of Neurology at the Mellen Center for Multiple Sclerosis Treatment and Research at the Cleveland Clinic in Ohio, United States of America (USA). Thank you, Dr. Amy Sullivan, for joining me today for this important discussion.
AS: Thank you, Mary. I am eager to dive into the discussion. My name is Dr. Amy Sullivan, and I am the Director of Engagement, Wellbeing for the Cleveland Clinic Neurological Institute and Director of Behavioral Medicine at the Mellen Center, and have the privilege of working directly with Dr. Rensel at the same organization. Today, we will address the critical issue of burnout among physicians treating patients with multiple sclerosis (MS). Specifically, we will focus on the findings of a quantitative survey conducted in the USA, which explored the prevalence of burnout and its associated risk factors. We will also discuss the possible impact of burnout on patient care and management as well as provide recommendations for addressing these challenges. To start, Mary, as a neurologist yourself treating MS, what are your thoughts on burnout among physicians treating patients with MS and the need for this study?
Understanding Physician Burnout in MS Care
MR: Yes, this is an important but often neglected issue. There is currently minimal data on burnout among physicians who are at the core of the healthcare system and work tirelessly to provide quality care to patients with MS. Let us understand the definition of burnout. According to the World Health Organization, burnout is a syndrome resulting from chronic workplace stress, characterized by energy depletion, mental distance, and reduced professional efficacy [ 1 ]. Burnout and stress among healthcare providers impair their ability to deliver optimal care and increase the overall burden on the healthcare system [ 2 ]. Neurologists, in particular, experience high rates of burnout. A 2024 Medscape report on physician burnout and depression revealed that 44% of neurologists report experiencing burnout [ 3 ]. This not only leads to decreased job satisfaction and early career exits but also discourages students from entering the field. Consequently, there is a growing shortage of qualified professionals to treat patients with neurological conditions [ 4 ]. This is especially concerning given the demands of managing chronic conditions such as MS.
AS: Indeed, MS is a chronic, progressive disease requiring ongoing comprehensive care [ 4 – 6 ], which can exacerbate burnout. Additional factors such as low reimbursement rates, a poor revenue-to-compensation ratio, and inadequate job support further contribute to the issue [ 4 ] [ 7 , 8 ]. Burnout significantly hampers a physician’s ability to provide optimal care, ultimately straining the healthcare system.
MR: There is a lack of published data specifically on burnout rates among physicians treating patients with MS. Through this discussion, we aim to explore this issue further, drawing from our experiences and the existing literature. Amy, since you were one of the consultants on the recent survey about this issue, could you share more about this study with our listeners?
Insights from the USA-Based Quantitative Survey
AS: To address this gap in the literature, a cross-sectional quantitative study of physicians treating patients with MS was conducted using an online questionnaire, sponsored and conducted by EMD Serono, an affiliate of Merck KGaA, with both of us serving as consultants. The study aimed to determine the prevalence of burnout and identify associated risk factors. Physicians were identified using datasets provided by IQVIA Inc., USA, and the survey planning was guided by a national healthcare professional burnout steering committee comprising neurologists across the USA. The survey was emailed to 3,951 physicians in the US who had prescribed more than three disease-modifying therapies for multiple sclerosis within a 12-month period, with up to five weekly follow-ups for non-responders. It included 20 questions, such as those from the validated Mini Z burnout survey v3.0 [ 9 ], along with questions related to demographic data, professional information, work environment, and job support. The data were analyzed descriptively to identify key findings and trends. All data were securely stored in compliance with the General Data Protection Regulation [ 10 ], access-controlled, and anonymized, with no personal identifiers recorded. Mary, you were also a consultant to this survey, and so now I’m going to hand this over to you to discuss the findings of this survey.
MR: Thank you. Overall, 136 physicians responded to the survey, with 115 completing it in full. Most respondents (71%) were white, with a nearly equal distribution of men (52%) and women (47%). Nearly all (99%) were aged over 30 years, and 55% were aged 50 years or over. The majority (90%) worked in academic medical centers, MS specialty practices, or general neurology practices. Notably, 50% of respondents reported feeling burned out or starting to experience burnout. Long working hours were the most cited contributor to job-related stress, with 54% of respondents working over 50 hours per week and nearly a third (27%) working more than 60 hours weekly. Additionally, 52% reported high levels of job-related stress. Electronic medical record (EMR)-related stress was another significant factor, with 74% of respondents identifying it as a source of frustration and 61% reporting high levels of stress related to EMR usage. Furthermore, 60% indicated that the time available for documentation was insufficient, and 59% reported that time spent completing EMRs at home was moderately high or excessive. Responses from the Mini Z survey showed that only 13% and 18% of participants described their workplace as “joyful” and “highly supportive,” respectively. Despite 80% expressing satisfaction with their jobs, nearly 50% had considered changing careers due to burnout. Among those considering a career change, 33% worked in academic medical centers, 33% in general neurology practices, and 23% in specialized MS practices, whereas the remaining 11% were employed in non-academic hospitals or other institutions.
Effects of Physician Job Satisfaction and Burnout on Patients
AS: Yeah, it is interesting to note that despite the presence of stressors, many respondents reported high job satisfaction. This might be attributed to deep personal satisfaction and a sense of purpose at work [ 6 ]. However, another study has highlighted low job satisfaction among neurologists experiencing burnout [ 4 ].
MR: Additionally, the high workload, reduced autonomy, clerical demands, and insufficient support staff contribute to widespread burnout, diminished clinical judgment and empathy, and dissatisfaction with career and work–life balance among neurologists in the USA [ 4 ]. Physicians across specialties, on average, spend approximately 33% of their time recording patient data in EMR systems [ 11 ]. The realization that valuable patient interaction time is being replaced by mandatory, inefficient EMR documentation further undermines job satisfaction and sense of purpose. This systemic inefficiency directly affects patient outcomes [ 12 ]. Additionally, a survey of MS care providers in the USA revealed that they often spend more time on both direct and indirect patient care compared to those treating other populations, with inadequate support for tasks such as managing portal messages. Respondents reported devoting a significant proportion of their working hours to portal activities and indirect care, much of which likely involves significant use of EMR system [ 5 ].
AS: Indeed, physicians continuing to work while managing burnout are more likely to deliver suboptimal care due to impaired decision-making and reduced empathy. This increases the likelihood of medical errors, ultimately compromising patient outcomes [ 12 , 13 ]. We believe that burnout can reach far beyond the job and can impact physicians’ health and well-being as well as family relationships. It is essential to identify and foster drivers of job satisfaction among physicians treating MS, such as supportive workplace relationships, autonomy, flexibility, and a sense of purpose. While this survey offers important insights into burnout among physicians treating patients with MS in the USA, there are a few considerations to consider. Mary, can you explain what those limitations are?
Limitations of the Study
MR: This study had certain limitations common to survey-based research, including challenges in ensuring the selection of appropriate respondents and reliance on their understanding and interpretation of the questions. Furthermore, the limited scope of the questionnaires, the small sample size, and the low response rate may limit the generalizability of the findings, as they might not accurately reflect the perspectives of all USA-based physicians treating patients with MS. Amy, what recommendations and future directions would you like to share with the physicians to integrate in their daily practice to manage burnout?
Recommendations and Future Directions
AS: Sure. Moving forward, we recommend the development of strategies for the early detection of burnout among physicians. This will facilitate the timely implementation of intervention and treatment of related mood disorders, potentially improving patient outcomes. This can be aided by fellow physicians, who play a crucial role in evaluating the clinical abilities and knowledge of their colleagues. The shared experience of the working environment places them in the best position to recognize those who could be vulnerable to complications arising from burnout [ 14 ].
Interventions should involve changes at the employer level, work environment enhancements, and personal stress alleviation strategies [ 15 ]. There is a pressing need for the redesign of EMRs to increase ease of use and decrease time requirements. EMR systems from different providers need to standardize common procedures and ensure seamless information exchange [ 7 , 16 ]. Organizational and work unit structures among US facilities employing neurologists should be proactively improved to enhance efficiency, reduce clerical tasks, and provide increased workplace flexibility and autonomy, along with adequate support staff [ 4 ]. Also, national policies that alleviate regulatory and clerical demands could foster enhanced engagement in neurology practice [ 7 ]. Mary, is there anything else you'd like to add?
MR: Yes, technology such as artificial intelligence (AI) could revolutionize healthcare by minimizing the administrative activities currently required of physicians for regulatory and billing purposes, such as documenting clinician notes and lab reports, imaging, filling EMRs, and answering questions on patient portals [ 17 , 18 ]. AI-based technologies to aid clinical decision-making and treat neurological disorders are now being implemented [ 17 ]. This shift will enable physicians to dedicate more time to patient care, using their clinical skills to enhance both the quality of care and patient experiences.
AS: Indeed, we need further studies to determine whether enhancements in EMR and AI can reduce burnout. A comprehensive wellness strategy to cope with the symptoms of burnout is also instrumental. Components of this strategy could include a focus on nurturing relationships, engaging in spiritual or religious practices, making fulfilling work choices, maintaining robust self-care routines, and adopting a life philosophy that balances personal and professional values [ 2 ]. This may enhance resilience, promote well-being, and improve the work–life balance of physicians. Mary, thanks so much for joining me to talk about the important issue of burnout among physicians treating patients with MS in the USA. Could you give us a quick summary of our discussion?
Summary/Take-Home Messages
MR: To summarize, our survey underscores the alarming prevalence of burnout among physicians treating MS, with EMR-related stress and long working hours being the key contributors.
Despite high levels of job satisfaction, many physicians contemplate leaving the field due to burnout. We hope that this discussion sheds light on the importance of addressing these pressing issues to improve both physician well-being and the quality of patient care.
AS: Thank you. We encourage all healthcare professionals to prioritize their well-being and seek adequate support when needed.
Acknowledgements
The authors thank the members of the National HCP Burnout Steering Committee, who were instrumental in developing the survey. The authors acknowledge Erica Zeplin-Pratt and Gretchen Terry Leonard from EMD Serono, Inc., Boston, MA, USA, an affiliate of Merck KGaA, for their contributions to the study design and implementation and for providing critical input during the development of the podcast. The podcast transcript has been edited for clarity.
Medical Writing/Editorial Assistance
Medical writing assistance was provided by Gaurav Anand of Merck Specialties Pvt. Ltd., Bengaluru, India, an affiliate of Merck KGaA, and funded by EMD Serono Research & Development Institute, Inc., Billerica, MA, USA, an affiliate of Merck KGaA.
Authorship
Mary Rensel and Amy B. Sullivan meet the authorship requirements of the International Committee of Medical Journal Editors (ICMJE) for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.
Author Contributions
Mary Rensel and Amy B. Sullivan made substantial contributions to the manuscript concept/design, critically reviewed and revised the manuscript drafts, and provided final approval of the manuscript and content as submitted.
Funding
This study, medical writing assistance, and publication charges associated with this article were funded and executed by EMD Serono Research & Development Institute, Inc., Billerica, MA, USA, an affiliate of Merck KGaA (CrossRef Funder ID: 10.13039/100004755).
Data Availability
Any requests for data by qualified scientific and medical researchers for legitimate research purposes will be subject to Merck’s Data Sharing Policy. All requests should be submitted in writing to Merck’s data sharing portal https://www.merckgroup.com/en/research/our-approach-to-research-and-development/healthcare/clinical-trials/commitment-responsible-data-sharing.html . When Merck has a co-research, co-development, or co-marketing or co-promotion agreement, or when the product has been out-licensed, the responsibility for disclosure might be dependent on the agreement between parties. Under these circumstances, Merck will endeavor to gain agreement to share data in response to requests.
Declarations
Conflict of Interest
Mary Rensel has received research funding from Biogen, the CBJ Foundation, Genentech, NMSS, and PPD as well as patient education funding from Genzyme. She has served on the Data and Safety Monitoring Committee for Biogen and has acted as a speaker/consultant for EMD Serono Research & Development Institute, Inc., Billerica, MA, USA, an affiliate of Merck KGaA, as well as for Genentech, Genzyme, Horizon, Improve Consulting, Kijia, MSAA, Novartis, and TG Therapeutics. She is also the founder of Brain Fresh. Amy B. Sullivan is a speaker/consultant for Amgen, Biogen, EMD Serono Research & Development Institute, Inc., Billerica, MA, USA, an affiliate of Merck KGaA, Genentech, MSAA, and Novartis.
Ethical Approval
This non-interventional survey received an Institutional Review Board exemption from the WCG IRB Affairs Department, Puyallup, Washington, USA, as it was a quantitative research study conducted with adult respondents. The study was conducted in accordance with international market research guidelines, and all data were securely stored in compliance with the General Data Protection Regulation, access-controlled, and anonymized. The participants provided their consent to participate in the survey and have their data published.
Footnotes
Mary Rensel and Amy B. Sullivan have contributed equally to this work.
References
Associated Data
Data Availability Statement
Any requests for data by qualified scientific and medical researchers for legitimate research purposes will be subject to Merck’s Data Sharing Policy. All requests should be submitted in writing to Merck’s data sharing portal https://www.merckgroup.com/en/research/our-approach-to-research-and-development/healthcare/clinical-trials/commitment-responsible-data-sharing.html . When Merck has a co-research, co-development, or co-marketing or co-promotion agreement, or when the product has been out-licensed, the responsibility for disclosure might be dependent on the agreement between parties. Under these circumstances, Merck will endeavor to gain agreement to share data in response to requests.
This survey provides key insights into the high prevalence of burnout and job stress among physicians treating patients with multiple sclerosis (MS) in the United States of America. The burnout rate among such physicians is alarmingly high, with 50% of respondents experiencing burnout or signs of burnout. Electronic medical record-related stress and extensive working hours were found to be significant contributors to burnout. Despite high job satisfaction, approximately 50% of the surveyed physicians had considered leaving the field because of burnout and related issues. This study may serve as a basis for future research aimed at improving the quality of life of physicians treating patients with MS, thereby reducing attrition and enhancing patient care.
Digital Features
This article is published with digital features, including podcast audio and an infographic, to facilitate understanding of the article. To view digital features for this article, go to 10.6084/m9.figshare.28653302.
Alternatively, the podcast can be found by searching "Adis Journal Podcast" with your preferred podcast platform.
Introduction
MR: Hello, and welcome to the “ Burnout Among Physicians Treating Patients with Multiple Sclerosis in the United States of America” podcast from the Adis journal Neurology and Therapy . I am Dr. Mary Rensel, Director of Wellness at the Department of Neurology at the Mellen Center for Multiple Sclerosis Treatment and Research at the Cleveland Clinic in Ohio, United States of America (USA). Thank you, Dr. Amy Sullivan, for joining me today for this important discussion.
AS: Thank you, Mary. I am eager to dive into the discussion. My name is Dr. Amy Sullivan, and I am the Director of Engagement, Wellbeing for the Cleveland Clinic Neurological Institute and Director of Behavioral Medicine at the Mellen Center, and have the privilege of working directly with Dr. Rensel at the same organization. Today, we will address the critical issue of burnout among physicians treating patients with multiple sclerosis (MS). Specifically, we will focus on the findings of a quantitative survey conducted in the USA, which explored the prevalence of burnout and its associated risk factors. We will also discuss the possible impact of burnout on patient care and management as well as provide recommendations for addressing these challenges. To start, Mary, as a neurologist yourself treating MS, what are your thoughts on burnout among physicians treating patients with MS and the need for this study?
Understanding Physician Burnout in MS Care
MR: Yes, this is an important but often neglected issue. There is currently minimal data on burnout among physicians who are at the core of the healthcare system and work tirelessly to provide quality care to patients with MS. Let us understand the definition of burnout. According to the World Health Organization, burnout is a syndrome resulting from chronic workplace stress, characterized by energy depletion, mental distance, and reduced professional efficacy [ 1 ]. Burnout and stress among healthcare providers impair their ability to deliver optimal care and increase the overall burden on the healthcare system [ 2 ]. Neurologists, in particular, experience high rates of burnout. A 2024 Medscape report on physician burnout and depression revealed that 44% of neurologists report experiencing burnout [ 3 ]. This not only leads to decreased job satisfaction and early career exits but also discourages students from entering the field. Consequently, there is a growing shortage of qualified professionals to treat patients with neurological conditions [ 4 ]. This is especially concerning given the demands of managing chronic conditions such as MS.
AS: Indeed, MS is a chronic, progressive disease requiring ongoing comprehensive care [ 4 – 6 ], which can exacerbate burnout. Additional factors such as low reimbursement rates, a poor revenue-to-compensation ratio, and inadequate job support further contribute to the issue [ 4 ] [ 7 , 8 ]. Burnout significantly hampers a physician’s ability to provide optimal care, ultimately straining the healthcare system.
MR: There is a lack of published data specifically on burnout rates among physicians treating patients with MS. Through this discussion, we aim to explore this issue further, drawing from our experiences and the existing literature. Amy, since you were one of the consultants on the recent survey about this issue, could you share more about this study with our listeners?
Insights from the USA-Based Quantitative Survey
AS: To address this gap in the literature, a cross-sectional quantitative study of physicians treating patients with MS was conducted using an online questionnaire, sponsored and conducted by EMD Serono, an affiliate of Merck KGaA, with both of us serving as consultants. The study aimed to determine the prevalence of burnout and identify associated risk factors. Physicians were identified using datasets provided by IQVIA Inc., USA, and the survey planning was guided by a national healthcare professional burnout steering committee comprising neurologists across the USA. The survey was emailed to 3,951 physicians in the US who had prescribed more than three disease-modifying therapies for multiple sclerosis within a 12-month period, with up to five weekly follow-ups for non-responders. It included 20 questions, such as those from the validated Mini Z burnout survey v3.0 [ 9 ], along with questions related to demographic data, professional information, work environment, and job support. The data were analyzed descriptively to identify key findings and trends. All data were securely stored in compliance with the General Data Protection Regulation [ 10 ], access-controlled, and anonymized, with no personal identifiers recorded. Mary, you were also a consultant to this survey, and so now I’m going to hand this over to you to discuss the findings of this survey.
MR: Thank you. Overall, 136 physicians responded to the survey, with 115 completing it in full. Most respondents (71%) were white, with a nearly equal distribution of men (52%) and women (47%). Nearly all (99%) were aged over 30 years, and 55% were aged 50 years or over. The majority (90%) worked in academic medical centers, MS specialty practices, or general neurology practices. Notably, 50% of respondents reported feeling burned out or starting to experience burnout. Long working hours were the most cited contributor to job-related stress, with 54% of respondents working over 50 hours per week and nearly a third (27%) working more than 60 hours weekly. Additionally, 52% reported high levels of job-related stress. Electronic medical record (EMR)-related stress was another significant factor, with 74% of respondents identifying it as a source of frustration and 61% reporting high levels of stress related to EMR usage. Furthermore, 60% indicated that the time available for documentation was insufficient, and 59% reported that time spent completing EMRs at home was moderately high or excessive. Responses from the Mini Z survey showed that only 13% and 18% of participants described their workplace as “joyful” and “highly supportive,” respectively. Despite 80% expressing satisfaction with their jobs, nearly 50% had considered changing careers due to burnout. Among those considering a career change, 33% worked in academic medical centers, 33% in general neurology practices, and 23% in specialized MS practices, whereas the remaining 11% were employed in non-academic hospitals or other institutions.
Effects of Physician Job Satisfaction and Burnout on Patients
AS: Yeah, it is interesting to note that despite the presence of stressors, many respondents reported high job satisfaction. This might be attributed to deep personal satisfaction and a sense of purpose at work [ 6 ]. However, another study has highlighted low job satisfaction among neurologists experiencing burnout [ 4 ].
MR: Additionally, the high workload, reduced autonomy, clerical demands, and insufficient support staff contribute to widespread burnout, diminished clinical judgment and empathy, and dissatisfaction with career and work–life balance among neurologists in the USA [ 4 ]. Physicians across specialties, on average, spend approximately 33% of their time recording patient data in EMR systems [ 11 ]. The realization that valuable patient interaction time is being replaced by mandatory, inefficient EMR documentation further undermines job satisfaction and sense of purpose. This systemic inefficiency directly affects patient outcomes [ 12 ]. Additionally, a survey of MS care providers in the USA revealed that they often spend more time on both direct and indirect patient care compared to those treating other populations, with inadequate support for tasks such as managing portal messages. Respondents reported devoting a significant proportion of their working hours to portal activities and indirect care, much of which likely involves significant use of EMR system [ 5 ].
AS: Indeed, physicians continuing to work while managing burnout are more likely to deliver suboptimal care due to impaired decision-making and reduced empathy. This increases the likelihood of medical errors, ultimately compromising patient outcomes [ 12 , 13 ]. We believe that burnout can reach far beyond the job and can impact physicians’ health and well-being as well as family relationships. It is essential to identify and foster drivers of job satisfaction among physicians treating MS, such as supportive workplace relationships, autonomy, flexibility, and a sense of purpose. While this survey offers important insights into burnout among physicians treating patients with MS in the USA, there are a few considerations to consider. Mary, can you explain what those limitations are?
Limitations of the Study
MR: This study had certain limitations common to survey-based research, including challenges in ensuring the selection of appropriate respondents and reliance on their understanding and interpretation of the questions. Furthermore, the limited scope of the questionnaires, the small sample size, and the low response rate may limit the generalizability of the findings, as they might not accurately reflect the perspectives of all USA-based physicians treating patients with MS. Amy, what recommendations and future directions would you like to share with the physicians to integrate in their daily practice to manage burnout?
Recommendations and Future Directions
AS: Sure. Moving forward, we recommend the development of strategies for the early detection of burnout among physicians. This will facilitate the timely implementation of intervention and treatment of related mood disorders, potentially improving patient outcomes. This can be aided by fellow physicians, who play a crucial role in evaluating the clinical abilities and knowledge of their colleagues. The shared experience of the working environment places them in the best position to recognize those who could be vulnerable to complications arising from burnout [ 14 ].
Interventions should involve changes at the employer level, work environment enhancements, and personal stress alleviation strategies [ 15 ]. There is a pressing need for the redesign of EMRs to increase ease of use and decrease time requirements. EMR systems from different providers need to standardize common procedures and ensure seamless information exchange [ 7 , 16 ]. Organizational and work unit structures among US facilities employing neurologists should be proactively improved to enhance efficiency, reduce clerical tasks, and provide increased workplace flexibility and autonomy, along with adequate support staff [ 4 ]. Also, national policies that alleviate regulatory and clerical demands could foster enhanced engagement in neurology practice [ 7 ]. Mary, is there anything else you'd like to add?
MR: Yes, technology such as artificial intelligence (AI) could revolutionize healthcare by minimizing the administrative activities currently required of physicians for regulatory and billing purposes, such as documenting clinician notes and lab reports, imaging, filling EMRs, and answering questions on patient portals [ 17 , 18 ]. AI-based technologies to aid clinical decision-making and treat neurological disorders are now being implemented [ 17 ]. This shift will enable physicians to dedicate more time to patient care, using their clinical skills to enhance both the quality of care and patient experiences.
AS: Indeed, we need further studies to determine whether enhancements in EMR and AI can reduce burnout. A comprehensive wellness strategy to cope with the symptoms of burnout is also instrumental. Components of this strategy could include a focus on nurturing relationships, engaging in spiritual or religious practices, making fulfilling work choices, maintaining robust self-care routines, and adopting a life philosophy that balances personal and professional values [ 2 ]. This may enhance resilience, promote well-being, and improve the work–life balance of physicians. Mary, thanks so much for joining me to talk about the important issue of burnout among physicians treating patients with MS in the USA. Could you give us a quick summary of our discussion?
Summary/Take-Home Messages
MR: To summarize, our survey underscores the alarming prevalence of burnout among physicians treating MS, with EMR-related stress and long working hours being the key contributors.
Despite high levels of job satisfaction, many physicians contemplate leaving the field due to burnout. We hope that this discussion sheds light on the importance of addressing these pressing issues to improve both physician well-being and the quality of patient care.
AS: Thank you. We encourage all healthcare professionals to prioritize their well-being and seek adequate support when needed.
Acknowledgements
The authors thank the members of the National HCP Burnout Steering Committee, who were instrumental in developing the survey. The authors acknowledge Erica Zeplin-Pratt and Gretchen Terry Leonard from EMD Serono, Inc., Boston, MA, USA, an affiliate of Merck KGaA, for their contributions to the study design and implementation and for providing critical input during the development of the podcast. The podcast transcript has been edited for clarity.
Medical Writing/Editorial Assistance
Medical writing assistance was provided by Gaurav Anand of Merck Specialties Pvt. Ltd., Bengaluru, India, an affiliate of Merck KGaA, and funded by EMD Serono Research & Development Institute, Inc., Billerica, MA, USA, an affiliate of Merck KGaA.
Authorship
Mary Rensel and Amy B. Sullivan meet the authorship requirements of the International Committee of Medical Journal Editors (ICMJE) for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.
Author Contributions
Mary Rensel and Amy B. Sullivan made substantial contributions to the manuscript concept/design, critically reviewed and revised the manuscript drafts, and provided final approval of the manuscript and content as submitted.
Funding
This study, medical writing assistance, and publication charges associated with this article were funded and executed by EMD Serono Research & Development Institute, Inc., Billerica, MA, USA, an affiliate of Merck KGaA (CrossRef Funder ID: 10.13039/100004755).
Data Availability
Any requests for data by qualified scientific and medical researchers for legitimate research purposes will be subject to Merck’s Data Sharing Policy. All requests should be submitted in writing to Merck’s data sharing portal https://www.merckgroup.com/en/research/our-approach-to-research-and-development/healthcare/clinical-trials/commitment-responsible-data-sharing.html . When Merck has a co-research, co-development, or co-marketing or co-promotion agreement, or when the product has been out-licensed, the responsibility for disclosure might be dependent on the agreement between parties. Under these circumstances, Merck will endeavor to gain agreement to share data in response to requests.
Declarations
Conflict of Interest
Mary Rensel has received research funding from Biogen, the CBJ Foundation, Genentech, NMSS, and PPD as well as patient education funding from Genzyme. She has served on the Data and Safety Monitoring Committee for Biogen and has acted as a speaker/consultant for EMD Serono Research & Development Institute, Inc., Billerica, MA, USA, an affiliate of Merck KGaA, as well as for Genentech, Genzyme, Horizon, Improve Consulting, Kijia, MSAA, Novartis, and TG Therapeutics. She is also the founder of Brain Fresh. Amy B. Sullivan is a speaker/consultant for Amgen, Biogen, EMD Serono Research & Development Institute, Inc., Billerica, MA, USA, an affiliate of Merck KGaA, Genentech, MSAA, and Novartis.
Ethical Approval
This non-interventional survey received an Institutional Review Board exemption from the WCG IRB Affairs Department, Puyallup, Washington, USA, as it was a quantitative research study conducted with adult respondents. The study was conducted in accordance with international market research guidelines, and all data were securely stored in compliance with the General Data Protection Regulation, access-controlled, and anonymized. The participants provided their consent to participate in the survey and have their data published.
Footnotes
Mary Rensel and Amy B. Sullivan have contributed equally to this work.
References
Associated Data
Data Availability Statement
Any requests for data by qualified scientific and medical researchers for legitimate research purposes will be subject to Merck’s Data Sharing Policy. All requests should be submitted in writing to Merck’s data sharing portal https://www.merckgroup.com/en/research/our-approach-to-research-and-development/healthcare/clinical-trials/commitment-responsible-data-sharing.html . When Merck has a co-research, co-development, or co-marketing or co-promotion agreement, or when the product has been out-licensed, the responsibility for disclosure might be dependent on the agreement between parties. Under these circumstances, Merck will endeavor to gain agreement to share data in response to requests.