Neurologist burnout – A Global phenomenon

We learned in January perhaps something that many of us already instinctly knew—burnout among U.S. neurologists is a real and probably growing problem1. This week in Neurology, U.S. Neurologists may be comforted somewhat to find they are not alone.

survey of the China Neurologist Association conducted by Zhou and colleagues found that 53% (compared to 41% in the US) of neurologists suffer from burn out and many of the associated factors such as longer work hours, more patients, and more night call coverage were shared risks of burn out in both the U.S. and Chinese respondents. There are some unique challenges in the Chinese healthcare sector that might be contributing to burnout including rising violence against physicians, possibly because of patient concerns that physician are enriching themselves at patient expense by inappropriate prescribing patterns2,3. Although there have been a number of recent reports on burnout among Chinese physicians 4-8, we don’t know whether neurologists there are disproportionately affected by burnout as they appear to be in the US. This would seem to be an important question to ask since if such a global phenomenon is occurring it may be telling us something important.


  1. Busis NA, Shanafelt TD, Keran CM, et al. Burnout, career satisfaction, and well-being among US neurologists in 2016. Neurology 2017;88:797-808.
  2. Burki T. China faces challenges to fix its pharmaceutical system. Lancet 2017;389:353-354.
  3. Beam C. Why Chinese patients are turning against their doctors. The New Yorker 2014.
  4. Ding Y, Qu J, Yu X, Wang S. The mediating effects of burnout on the relationship between anxiety symptoms and occupational stress among community healthcare workers in China: a cross-sectional study. PLoS One 2014;9:e107130.
  5. Gong Y, Han T, Chen W, et al. Prevalence of anxiety and depressive symptoms and related risk factors among physicians in China: a cross-sectional study. PLoS One 2014;9:e103242.
  6. Jin WM, Zhang Y, Wang XP. Job burnout and organizational justice among medical interns in Shanghai, People’s Republic of China. Adv Med Educ Pract 2015;6:539-544.
  7. Wen J, Cheng Y, Hu X, Yuan P, Hao T, Shi Y. Workload, burnout, and medical mistakes among physicians in China: A cross-sectional study. Biosci Trends 2016;10:27-33.
  8. Xiao Y, Wang J, Chen S, et al. Psychological distress, burnout level and job satisfaction in emergency medicine: A cross-sectional study of physicians in China. Emerg Med Australas 2014;26:538-542.
Gretchen L. Birbeck, MD, MPH

Gretchen L. Birbeck, MD, MPH

Gretchen Birbeck is a neurologist who divides her time between the US and Africa. Her US academic home is the University of Rochester where she is the Rykenboer Professor of Neurology and Research Director for the Strong Epilepsy Center with adjunct appointments in the Center for Human Experimental Therapeutics and the Department of Public Health. Her additional skills in epidemiology, health services research, and tropical medicine are brought to bear during the 6-months annually she spends in Africa where she serves as Director for the Chikankata Epilepsy Care Team in rural Mazabuka, Zambia, an Honorary Lecturer at the University of Zambia and a consultant for the Paediatric Research Ward at Queen Elizabeth Central Hospital in Blantyre, Malawi. Gretchen’s research programs are aimed at identifying opportunities to prevent or ameliorate the medical and social morbidities of common neurologic conditions in low-income, tropical settings with the ultimate goal of developing successful interventions feasible for scale up and broad implementation. She has been recognized as an Ambassador for Epilepsy by the International League against Epilepsy, a Global Health Research Ambassador by the US Paul Rogers Society, a National Outreach Scholar by the WK Kellogg Foundation and a Leader in Medicine by the American Medical Students Association.

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