The majority of physicians in the U.S. are burned out, depressed or both, according to a new survey.

With more than 15,000 practicing physicians responding across 29 specialties, the majority of physicians reported experiencing burnout (42 percent), depression (15 percent) or both (14 percent).

"Physicians tell us that the primary stressors that lead to burnout are increasing bureaucratic demands, high patient load, and loss of autonomy," Leslie Kane, senior director of Medscape’s Business of Medicine, told HCB News.

The report, entitled Medscape National Report on Physician Burnout and Depression, found that mid-career and female physicians are the most affected.

Signs of burnout include physical, emotion or mental exhaustion, frustration or cynicism about work, and doubts about one’s experience and value of their work. Forty-two percent of the physicians reported having these symptoms.

Of the 15 percent experiencing depression, 12 percent said they “feel down” and 3 percent experience serious depression. Most of them cited their work as the cause of the depression.

Among the 29 specialties included in the report, family physicians, intensivists, internists, neurologists and OB-GYNs had the highest rates of burnout. Alternatively, plastic surgeons, dermatologists, pathologists and ophthalmologists had the lowest rates.

"With regard to family physicians, there are reports that have shown that a high workload and lower rates of pay increase burnout levels, and for neurologists, we see a specialty dealing with complex, chronic and severely debilitating brain diseases," said Kane.

She added that the EHR slows physicians down and eats up a large amount of their time. For physicians who see patients in relatively short time frames such as primary care physicians, it's difficult for them to stay on schedule and there isn't much time to decompress during the day.

A study published in the Journal of General Internal Medicine in October 2016 made a connection between higher rates of physician burnout and lower quality of care and patient safety. The new report found that 32 percent of physicians were less engaged with patients and 29 percent were less friendly due to depression.

Almost 15 percent disclosed that their depression may lead them to make errors that they usually wouldn’t make. Five percent attributed it to errors they had made that could have harmed a patient.

To alleviate burnout, 56 percent of the physicians are asking for fewer bureaucratic tasks and 39 percent need to spend fewer hours working. About one-third said an increase in pay and a more manageable work schedule would also help.

Most of the physicians do not seek professional help for burnout or depression. Instead, about half exercise and talk with family or friends, one-third eat junk food, and one in five drink alcohol or binge eat.

"There is a stigma attached to having an emotional or mental health concern, and it is exacerbated by the fact that doctors can risk privileges or face licensing restrictions," said Kane.

She added that physicians need to make use of the growing availability of resources and programs created to prevent burnout and reduce stress. Many organizations including including academic medical centers and professional organizations offer those types of programs.

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