In the Journals

More than half of US physicians experiencing professional burnout

A survey analysis found that professional burnout is increasing among physicians in the United States, according to data published in Mayo Clinic Proceedings.

Tait D. Shanafelt , MD, at the division of hematology at the Mayo Clinic, and colleagues stated that 54.4% of physicians reported at least one symptom of burnout in their investigation.

"Once in practice, physicians have generally high degrees of satisfaction with their career choice but experience high degrees of professional burnout and dissatisfaction with work-life integration," Shanafelt and colleagues wrote. "Burnout is a syndrome of emotional exhaustion, loss of meaning in work, feelings of ineffectiveness and a tendency to view people as objects rather than as human beings. Burnout has profound implications for individual physicians and their families."

Tait D. Shanafelt

Tait D. Shanafelt

The researchers surveyed a sample of physicians from all specialties as well as a sample of individuals from the general population for comparison, similar to the method used in a previous study. Surveys included the Maslach Burnout Inventory and the 2-item Primary Care Evaluation of Mental Disorders. The final population consisted of 6,880 physicians who completed the survey and 5,392 employed nonphysicians.

Results showed that physicians reported emotional exhaustion (46.9%), depersonalization (34.6%) and low sense of personal accomplishment (16.3%). Shanafelt and colleagues reported that in aggregate, 54.4% of physicians had at least one symptom of burnout and 40.9% reported that their professional schedules left enough family or personal time.

Burnout rates were higher (54.4% vs. 45.5%; P < .001) and work-life balance was lower (40.9% vs. 48.5%; P < .001) in 2014 compared with 2011.

The researchers also found that burnout prevalence had increased within each specialty since 2011 and many had increased by more than 10%, including: family medicine (51.3% vs. 63%; P < .001), general pediatrics (35.3% vs. 46.3%; P = .005), urology (41.2% vs. 63.6%; P < .001), orthopedic surgery (48.3% vs. 59.6%; P = .01), dermatology (31.8% vs. 56.5%; P < .001), physical medicine and rehabilitation (47.4% vs. 63.3%; P = .01), pathology (37.6% vs. 52.5%; P = .006), radiology (47.7% vs. 61.4%; P = .003), and general surgery subspecialties (42.4% vs. 52.7%; P = .005).

Compared with the general population, physicians reported higher emotional exhaustion (43.2% vs. 24.8%; P < .001), depersonalization (23% vs. 14%; P < .001) and overall burnout (48.8% vs. 28.4%; P < .001). Additionally, compared with the general population, physicians reported lower satisfaction with work-life balance (36% vs. 61.3%; P < .001).

After adjusting for age, sex, relationship status and hours worked per week, physicians were still at an increased risk for burnout (OR = 1.97; 95%CI, 1.8-2.16; P < .001) and were less likely to be satisfied with work-life balance (OR = 0.68; 95% CI, 0.62-0.75; P < .001) than the general population.

"Burnout and satisfaction with [work-life balance] among U.S. physicians are getting worse," Shanafelt and colleagues wrote. "American medicine appears to be at a tipping point with more than half of U.S. physicians experiencing professional burnout. Given the extensive evidence that burnout among physicians has effects on quality of care, patient satisfaction, turnover and patient safety, these findings have important implications for society at large."

The researchers called for the systemic implementation of evidence-based interventions.

"These interventions must address contributing factors in the practice environment rather than focusing exclusively on helping physicians care for themselves and training them to be more resilient," they wrote. – by Chelsea Frajerman Pardes

Disclosures: Shanafelt is the co-inventor of the Physician Well-being Index.

A survey analysis found that professional burnout is increasing among physicians in the United States, according to data published in Mayo Clinic Proceedings.

Tait D. Shanafelt , MD, at the division of hematology at the Mayo Clinic, and colleagues stated that 54.4% of physicians reported at least one symptom of burnout in their investigation.

"Once in practice, physicians have generally high degrees of satisfaction with their career choice but experience high degrees of professional burnout and dissatisfaction with work-life integration," Shanafelt and colleagues wrote. "Burnout is a syndrome of emotional exhaustion, loss of meaning in work, feelings of ineffectiveness and a tendency to view people as objects rather than as human beings. Burnout has profound implications for individual physicians and their families."

Tait D. Shanafelt

Tait D. Shanafelt

The researchers surveyed a sample of physicians from all specialties as well as a sample of individuals from the general population for comparison, similar to the method used in a previous study. Surveys included the Maslach Burnout Inventory and the 2-item Primary Care Evaluation of Mental Disorders. The final population consisted of 6,880 physicians who completed the survey and 5,392 employed nonphysicians.

Results showed that physicians reported emotional exhaustion (46.9%), depersonalization (34.6%) and low sense of personal accomplishment (16.3%). Shanafelt and colleagues reported that in aggregate, 54.4% of physicians had at least one symptom of burnout and 40.9% reported that their professional schedules left enough family or personal time.

Burnout rates were higher (54.4% vs. 45.5%; P < .001) and work-life balance was lower (40.9% vs. 48.5%; P < .001) in 2014 compared with 2011.

The researchers also found that burnout prevalence had increased within each specialty since 2011 and many had increased by more than 10%, including: family medicine (51.3% vs. 63%; P < .001), general pediatrics (35.3% vs. 46.3%; P = .005), urology (41.2% vs. 63.6%; P < .001), orthopedic surgery (48.3% vs. 59.6%; P = .01), dermatology (31.8% vs. 56.5%; P < .001), physical medicine and rehabilitation (47.4% vs. 63.3%; P = .01), pathology (37.6% vs. 52.5%; P = .006), radiology (47.7% vs. 61.4%; P = .003), and general surgery subspecialties (42.4% vs. 52.7%; P = .005).

Compared with the general population, physicians reported higher emotional exhaustion (43.2% vs. 24.8%; P < .001), depersonalization (23% vs. 14%; P < .001) and overall burnout (48.8% vs. 28.4%; P < .001). Additionally, compared with the general population, physicians reported lower satisfaction with work-life balance (36% vs. 61.3%; P < .001).

After adjusting for age, sex, relationship status and hours worked per week, physicians were still at an increased risk for burnout (OR = 1.97; 95%CI, 1.8-2.16; P < .001) and were less likely to be satisfied with work-life balance (OR = 0.68; 95% CI, 0.62-0.75; P < .001) than the general population.

"Burnout and satisfaction with [work-life balance] among U.S. physicians are getting worse," Shanafelt and colleagues wrote. "American medicine appears to be at a tipping point with more than half of U.S. physicians experiencing professional burnout. Given the extensive evidence that burnout among physicians has effects on quality of care, patient satisfaction, turnover and patient safety, these findings have important implications for society at large."

The researchers called for the systemic implementation of evidence-based interventions.

"These interventions must address contributing factors in the practice environment rather than focusing exclusively on helping physicians care for themselves and training them to be more resilient," they wrote. – by Chelsea Frajerman Pardes

Disclosures: Shanafelt is the co-inventor of the Physician Well-being Index.