2/3 of ER Physicians Reported Burnout in 2024 — Here's Why I Was One of Them

According to the 2024 Medscape Physician Burnout & Depression Report ("We Have Much Work to Do"), 49% of physicians reported feelings of burnout or depression. Emergency medicine physicians stood out from the rest, with a striking 63% reporting burnout. Rates in this specialty escalated dramatically during the COVID-19 pandemic—and unfortunately, they have remained high ever since. Prior to the pandemic, emergency medicine was about average among specialties in burnout rates.

Of those reporting burnout, 83% said it was either entirely (30%) or mostly (53%) job-related.

Here are the top reported reasons for job-related burnout:

Too many bureaucratic tasks (e.g., charting, paperwork) – 62%
Too many hours at work – 41%
Lack of respect from administrators, colleagues, or staff – 40%
Insufficient compensation – 38%
Lack of control/autonomy – 32%
Computerization of practice (EHR) – 24%
Lack of respect from patients – 22%
Government regulations – 13%
Other – 9%

These top three have remained consistent for years.

Between 14–16% of physicians reported that their burnout was so severe they were considering leaving medicine altogether. In fact, 30–40% said there was a likelihood they would leave their current practice within two years—though only about one-third of those actually do.

Interestingly, 31% of physicians reported that finances were a significant contributing factor to their burnout.

A separate report, Seeking Solutions to Burnout Among Emergency Physicians, focused specifically on EM and outlined several contributing factors:

Workload
Nursing shortages
Moral injury
The boarding crisis
Employment structures
Trauma related to the job

It's one thing to read a report filled with statistics. It's another thing entirely to live it.

I’m an emergency physician. And yes, I’ve experienced burnout myself. When I tried to analyze my own reasons, this is the list I came up with:

1. Career Stagnation

I’ve moved around a fair bit for personal and family reasons, which meant changing jobs. When I joined my last group in 2017, I was experienced and had leadership background—but I started at the bottom of the group hierarchy again. There weren’t immediate leadership opportunities, and I didn’t push for them. I figured younger members should get their chance. After all, I was on the downhill slope of my career. But that led to a lack of personal growth and a sense that I was just there to pull shifts. I don’t do well with stagnation. It always leads to an itch to do something different.

2. Compassion Fatigue

In the ED, we see every type of person with every type of complaint—and every type of demand. It can be hard to maintain empathy. This was made worse during COVID, when people—angry at the government over restrictions—would come into the ED, put staff at risk, and demand their own versions of care. That mentality hasn’t gone away… or maybe I’ve just grown more sensitive to it.

3. Lack of Control

Anything can happen on any shift in the ED. That’s part of what drew me to the specialty—the excitement and unpredictability. But after years of practice and thousands of patients with the same complaints, the novelty fades. What’s left is the relentless volume, and the complete inability to control how busy your day will be. That unpredictability becomes a burden over time.

4. Counterproductive Administrative Decisions

This is a tale as old as time in medicine, but COVID made it worse. Decisions to furlough or fire staff during slowdowns led to massive staffing shortages when volumes rebounded. That created unsafe situations and compromised patient care. Hospital administrators still don’t seem to realize that prioritizing the bottom line over patients and providers is a short-sighted and harmful way to run a healthcare system.

5. The ED Dumping Syndrome

The ED has become the safety net for a broken healthcare system.

No insurance? Go to the ED.

Medicaid? The ED is essentially free.

Insurance, but no doctor? ED.

Doctor, but no appointments for weeks? ED.

Busy clinic schedule? Send to the ED.

And the ED can’t turn anyone away. It gets exhausting.

6. Commoditization of Physicians

It feels like physicians are losing respect. Patients are more likely to challenge you, less likely to trust you. Healthcare systems try to replace us with cheaper, less-trained providers. More and more physicians are becoming employees of giant corporations that prioritize spreadsheets over clinical autonomy. It feels like we’re becoming interchangeable parts—just another warm body.

7. Starfish Syndrome

You’ve probably heard the story: thousands of starfish wash up on the beach. A man throws them back in, one by one. When told he couldn’t possibly make a difference, he replies, “It makes a difference to this one.”

That’s what it can feel like in the ED. The starfish just keep coming. You do make a difference—but when you see the same names over and over again, and the chart says this is their fourth visit in two weeks, your arm gets tired.

8. Decrease in Meaningful Relationships

In The Purpose Code, Jordan Grumet teaches that the path to lasting happiness is by creating deep relationships. Some physicians get that with their patients. But ED doctors rarely do. Our interactions are brief. They can still be meaningful, but it’s harder to create true connection. I also work across multiple facilities, often as the only physician. Nurses and staff change frequently. Sometimes I don’t even remember the names of the people that I’m working with that day.

9. Night Shifts

This one’s simple. Night shifts have worn me down. As I get older, the switch between nights and days gets harder—and sleeping well during the day is nearly impossible. Our group reduces night shifts over time, but that’s based on seniority, not age. Since I joined late, I still do them. And each one takes a bigger toll on my body.

So those are some of the reasons I burned out—and why I began looking for something else.

I'd love to hear your experiences in the comments. What are the causes of burnout in your specialty? What helped? What didn’t?

In my next post, I’ll talk about what I did about it—and what you can do, whether you're facing burnout now or want to prevent it in the future. Stay tuned.