Exacerbated by the COVID-19 pandemic, doctor burnout continues to increase globally, prompting a call from the world's four leading cardiovascular organizations for better efforts to support cardiologists' mental health.

The joint statement cited recent survey data finding more than one-fourth of U.S. cardiologists and fellows-in-training were feeling burned out and nearly half reported feeling stressed. The problem was even more pronounced in women than men.

The statement was issued Tuesday by the American Heart Association, American College of Cardiology, European Society of Cardiology and World Heart Federation. It was published simultaneously in each organization's flagship journal, including the AHA's journal Circulation.

"Over the last several decades, there have been significant changes in health care with the expansion of technology, regulatory burden and clerical task loads. These developments have come at a cost to the well-being and work-life integration of clinicians," Dr. Athena Poppas, immediate past president of ACC and co-author of the joint opinion, said in a news release.

"The COVID-19 pandemic has caused additional strain on clinicians through increased patient mortality, personal and family safety concerns, fear of the unknown and increased work demands," she said.

The report describes clinician well-being as feeling satisfied and engaged with work, having a feeling of professional fulfillment and a sense of meaning. Burnout occurs when doctors feel emotionally exhausted and have a low sense of personal accomplishment in a stressful work environment. It may be accompanied by anxiety and depression. Drivers of burnout include not having enough control over workload, a hectic work environment, misaligned values and not enough time to do paperwork.

Women, who are underrepresented in cardiology, may have added stressors such as not getting deserved promotions, being paid less and not getting as much mentoring as men in the same positions.

"These stressors compound over time, and collectively, they diminish our abilities to provide high-quality patient care and to strengthen and diversify our workforce. In addition, stigma related to mental health care must be eradicated," Dr. Mitchell Elkind, immediate past president of the AHA, said in the release.

"As clinicians, we continuously strive for the improved health of our patients and at the same time recognize our own welfare is paramount to them receiving optimal care," the report's lead author, Dr. Laxmi Mehta, said in the release. Mehta is section director of preventive cardiology and women's cardiovascular health, and vice chair of wellness in the department of internal medicine at The Ohio State University Wexler Medical Center.

On the job, clinical burnout can lead to more medical errors, lower-quality care, decreased patient satisfaction and loss of professionalism. Among doctors, it also may contribute to higher rates of alcohol abuse, substance use, dysfunctional relationships, depression and suicide.

The joint statement urges health care organizations and medical specialty societies to provide doctors and other health care workers with greater access to mental health resources, to reduce the stigma of using those resources and to create a confidential means of reporting mistreatment. It also encourages creating more diverse and inclusive work environments so all employees feel valued.

"Our organizations are joined together in this report to ensure that we create a strong and supportive clinician environment – for our personal well-being and for our families, loved ones and patients," Elkind said. "Well-being is essential to achieving personal fulfilment and satisfaction in our work."

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