Burnout has been defined as a syndrome of emotional exhaustion, depersonalization, and feelings of ineffectiveness.
“Burnout has profound implications for physicians, patients, and their families,” says Colin P. West, MD, PhD, FACP. “Studies indicate that burnout can impact the quality of care that physicians provide, which in turn can negatively impact the overall quality of healthcare delivery.”
Recent reports have shown the burnout rates vary substantially based on specialty and career stage. In 2011, a national study showed that about 45% of physicians in the United States met criteria for burnout. “We need to continue to examine the landscape of medicine because of its rapid evolution,” says Dr. West. “Several emerging factors can influence burnout and job satisfaction, including technology, legislation, and market forces as well as fluctuating reimbursement, new healthcare delivery models, and increased productivity expectations.”
For a study published in Mayo Clinic Proceedings, Dr. West and colleagues reevaluated data from the aforementioned 2011 analysis with regard to burnout and satisfaction with work-life balance over a period of about 3 years. Of the nearly 7,000 participants who completed the survey, more than half—nearly 55%—of physicians reported at least one symptom of burnout, representing a significant jump from the 45% rate that was seen in 2011. “With more than half of physicians reporting being burned out, it’s clear that this is a pervasive problem that appears to worsening,” says Dr. West.
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The study also revealed that satisfaction with work-life balance declined in physicians between from 2011 to 2014. “The increase in burnout and decrease in satisfaction with work-life balance in physicians over the last 3 years was contrary to trends seen in the general U.S. working population over the same time period,” adds Dr. West. After the authors pooled and adjusted data for age, sex, relationship status, and hours worked per week, physicians were still at higher risk for burnout (odds ratio, 1.97) and were less likely to be satisfied with work-life balance (odds ratio, 0.68) when compared with the general population.
“There is an urgent need to develop interventions that address the drivers of burnout among physicians,” Dr. West says. “These interventions should focus on contributing factors in the practice environment rather than focusing exclusively on helping doctors care for themselves and training them to be more resilient. This includes improving electronic patient management systems so that doctors are treating patients more than dealing with their computers.”
The study notes that healthcare organizations should select and develop leaders with the skills to foster physician engagement and help physicians optimize their career fit. “They should also create an environment that nurtures community, flexibility, and control, all of which help cultivate meaning in work,” says Dr. West.
Considering the unpredictable nature of work hours in some settings, it is important to establish principles that help facilitate work-life integration. Organizational approaches to help physicians self-calibrate and promote their own wellness may also be beneficial. Physicians need guidance in identifying their personal and professional values and determining how to prioritize them when conflicts arise. “Given the significant burden that burnout can have on doctors and patient outcomes, our findings have important implications for physicians and society at large,” Dr. West says.
Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proceed. 2015;90:1600-1613.
Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172:1377-1385.
Dyrbye LN, West CP, Satele D, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. 2014;89:443-451.