Neurology and Neurosurgery

Oct. 02, 2020

An American Academy of Neurology task force highlighted a growing shortage of U.S. neurologists — 11% in 2012, and a predicted 19% by 2025. Addressing factors that can contribute to this shortage, such as the gender gap and physician burnout, is key. Mayo Clinic physicians and researchers Marion (Toni) T. Turnbull, Ph.D., Maisha T. Robinson, M.D., Elizabeth A. Mauricio, M.D., and William D. Freeman, M.D., published an article in Neurology in 2019 focused on burnout and attrition and the expanding gender gap.

Some of the key highlights from the published article are below.

• There continues to be a gender gap in neurology. In 2012, women made up only 32% of the neurology workforce; in 2016, only 31.5% of American Academy of Neurology members were women.
• At least 60% of neurologists report one symptom of burnout, including depersonalization, emotional exhaustion and low sense of accomplishment.
• Some studies suggest burnout to be as much as 20% to 60% higher among women than men.
• A prospective study of burnout and satisfaction among Mayo Clinic physicians found a "dose-response relationship" between changes in emotional exhaustion and satisfaction and reductions in full-time employment. The authors comment that while choosing to work part time is "preferable to a physician leaving practice altogether" and may improve satisfaction and the sense of control, it may adversely affect the physician workforce shortage and lessen continuity of care.
• If a neurologist decides to do more research or administration at the expense of direct patient care, is that effectively attrition? Similarly, taking more leave time, cutting hours and experiencing loss of productivity due to burnout are all forms of attrition, which might better be called soft attrition.
• It would be worrisome if the greater percentage of women entering neurology were to be counterbalanced by an increased attrition, or soft attrition, rate. This situation could result in a net future shortage of neurologists that is greater than that predicted by the earlier model from the 2012 American Academy of Neurology Work Force Task Force study and would have negative implications for the sustainability of an effective neurologist workforce.

For more information

Hasan TF, et al. Burnout and attrition: Expanding the gender gap in neurology? Neurology. 2019;93:1002.