Endocrinologists are among the least happy of all medical specialists, a new Medscape survey finds. 

In the wide-ranging Medscape Endocrinologist Lifestyle, Happiness & Burnout Report 2020 , less than one quarter (23%) of endocrinologists reported themselves to be "very" or "extremely" happy at work, with only rheumatologists, internists, and neurologists scoring lower on that metric. 

Like everyone else, endocrinologists are happier outside of work. But even there, just under half (49%) were very or extremely happy, tying with gastroenterologists and topping only internists, critical care specialists, and neurologists. 

The findings are based on responses from 15,181 physicians across 29 specialities who answered the 10-minute online survey conducted June to September of last year. About 1% of respondents were endocrinologists. 

More endocrinologists reported being "burned out" than depressed (31% vs 2%), although a sizable 16% reported having both burnout and depression. And of great concern, almost 1 in 5 reported having thoughts of suicide. 

Asked about possible causes of the burnout, 77% endorsed "too many bureaucratic tasks," 46% listed "insufficient compensation/reimbursement," 34% replied "increasing computerization of practice (electronic health records)," and 33% said "spending too many hours at work." 

Regarding compensation, a 2019 Medscape report had found that while endocrinologist salaries had increased from $212,000 in 2018 to $236,000 in 2019, they still ranked near the bottom in specialist pay, surpassing only physicians in public health/preventive medicine, pediatrics, and family medicine. 

Junk Food, Isolation, Alcohol Are Among Coping Strategies 

The current survey also found that endocrinologists aren't always coping well with burnout. While 42% said they "talk with family members/close friends" to cope, another 39% reported eating junk food, 35% said they isolate themselves from others, 20% drink alcohol, and 12% binge-eat. 

While 37% said they exercise to cope with burnout, overall 52% reported exercising only three times a week or less. Other coping strategies included sleeping (35%) and playing/listening to music (25%). 

Alarmingly, 19% reported having thoughts of suicide, although no respondent had actually attempted it. Just 12% reported that they were currently seeking professional help to cope with burnout and/or depression and 18% had previously done so. 

The majority, 60%, hadn't ever sought professional mental health care. Asked why not, 45% cited "too busy," 40% responded "symptoms not severe enough," and 36% said "I can deal with this without help from a professional." A smaller proportion, 13%, feared risking disclosure. 

On the Brighter Side, Most Report Happy Marriages 

On a more positive note, over 80% of endocrinologists are married or in a committed relationship. And of those, a large majority describe their marriage/relationship as "very good" or "good." 

Intriguingly, the proportion listing their marriage as "very good" was considerably higher for men (70%) than for women (47%). 

Overall, endocrinologists ranked third-highest among specialities in reporting high satisfaction with their marriages, 60%, topped only by nephrologists and physical medicine/rehabilitation specialists (61% each). 

Endocrinologists reported typically taking either 1-2 or 3-4 weeks of vacation per year, 39% and 43%, respectively. 

Asked whether they spend "enough time on their own personal health and wellness," just 6% said they "always" do and only 30% do so "most of the time." The majority either do so only sometimes (39%) or rarely (25%).