Social Isolation and Burnout, Professional Fulfillment, and Suicidal Ideation Among US Physicians

To determine the degree of social isolation experienced by US physicians and evaluate the relationship of social isolation with personal and professional characteristics, burnout, professional fulfillment, and suicidal ideation.

Between November 20, 2020, and March 23, 2021, we surveyed US physicians and a probability-based sample of the US working population. Social isolation was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) 4-item social isolation instrument. Burnout and professional fulfillment were measured using standardized instruments. Suicidal ideation during the past 12 months was assessed using a single dichotomous item.

Among 3103 physician responders, the mean T-score for social isolation was 48.2 (range, 0-100). Social isolation scores were higher for women than men physicians (mean, 49.7 vs 47.4; P<.001) and were lower among married physicians. Proportions with overall burnout, lowest quartile professional fulfillment, and suicidal ideation in the previous 12 months were 65.7%, 47.0%, and 14.8%, respectively, in the worst-quartile social isolation group vs 15.3%, 7.7%, and 2.3% in the best-quartile social isolation group (all P<.001). For each 1-point higher social isolation score, the odds of burnout, lowest-quartile professional fulfillment, and reporting suicidal ideation were 10% higher (odds ratio [OR] burnout, 1.10; 95% CI, 1.09 to 1.12; P<.001), 11% higher (OR lowest-quartile professional fulfillment, 1.11; 95% CI, 1.09 to 1.12; P<.001), and 9% higher (OR suicidal ideation, 1.09; 95% CI, 1.07 to 1.11; P<.001). On multivariable analysis, physicians were more likely to report "I feel isolated from others" than workers in other fields (OR, 1.28; 95% CI, 1.15 to 1.43; P<.001).

Social isolation is associated with increased burnout, suicidal ideation, and lower professional fulfillment, and is more common among US physicians than workers in other fields.