Physician Satisfaction and Burnout at Different Career Stages
01 Dec 2013-Vol. 88, Iss: 12, pp 1358-1367
TL;DR: Burnout, satisfaction, and other professional challenges for physicians vary by career stage, and efforts to promote career satisfaction, reduce burnout, and facilitate retention need to be expanded beyond early career interventions and may needs to be tailored by Career stage.
Abstract: Objective To explore the work lives, professional satisfaction, and burnout of US physicians by career stage and differences across sexes, specialties, and practice setting. Participants and Methods We conducted a cross-sectional study that involved a large sample of US physicians from all specialty disciplines in June 2011. The survey included the Maslach Burnout Inventory and items that explored professional life and career satisfaction. Physicians who had been in practice 10 years or less, 11 to 20 years, and 21 years or more were considered to be in early, middle, and late career, respectively. Results Early career physicians had the lowest satisfaction with overall career choice (being a physician), the highest frequency of work-home conflicts, and the highest rates of depersonalization (all P P Conclusion Burnout, satisfaction, and other professional challenges for physicians vary by career stage. Middle career appears to be a particularly challenging time for physicians. Efforts to promote career satisfaction, reduce burnout, and facilitate retention need to be expanded beyond early career interventions and may need to be tailored by career stage.
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01 Dec 2015
TL;DR: Burnout and satisfaction with work-life balance in US physicians worsened from 2011 to 2014, resulting in an increasing disparity in burn out and satisfaction in physicians relative to the general US working population.
Abstract: Objective To evaluate the prevalence of burnout and satisfaction with work-life balance in physicians and US workers in 2014 relative to 2011. Patients and Methods From August 28, 2014, to October 6, 2014, we surveyed both US physicians and a probability-based sample of the general US population using the methods and measures used in our 2011 study. Burnout was measured using validated metrics, and satisfaction with work-life balance was assessed using standard tools. Results Of the 35,922 physicians who received an invitation to participate, 6880 (19.2%) completed surveys. When assessed using the Maslach Burnout Inventory, 54.4% (n=3680) of the physicians reported at least 1 symptom of burnout in 2014 compared with 45.5% (n=3310) in 2011 ( P P P P Conclusion Burnout and satisfaction with work-life balance in US physicians worsened from 2011 to 2014. More than half of US physicians are now experiencing professional burnout.
2,150 citations
Cites background from "Physician Satisfaction and Burnout ..."
...Burnout among physicians also varied by career stage, with the highest rate among midcareer physicians.(21) Burnout was more common among physicians than among the general US working population, a finding that persisted after adjusting for age, sex, hours worked, and level of education....
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TL;DR: All stakeholders in healthcare delivery must work together to develop and implement effective remedies for physician burnout, and organizational efforts such as locally developed practice modifications and increased support for clinical work have demonstrated benefits in reducing burnout.
Abstract: Physician burnout, a work-related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment, is prevalent internationally. Rates of burnout symptoms that have been associated with adverse effects on patients, the healthcare workforce, costs and physician health exceed 50% in studies of both physicians-in-training and practicing physicians. This problem represents a public health crisis with negative impacts on individual physicians, patients and healthcare organizations and systems. Drivers of this epidemic are largely rooted within healthcare organizations and systems and include excessive workloads, inefficient work processes, clerical burdens, work-home conflicts, lack of input or control for physicians with respect to issues affecting their work lives, organizational support structures and leadership culture. Individual physician-level factors also play a role, with higher rates of burnout commonly reported in female and younger physicians. Effective solutions align with these drivers. For example, organizational efforts such as locally developed practice modifications and increased support for clinical work have demonstrated benefits in reducing burnout. Individually focused solutions such as mindfulness-based stress reduction and small-group programmes to promote community, connectedness and meaning have also been shown to be effective. Regardless of the specific approach taken, the problem of physician burnout is best addressed when viewed as a shared responsibility of both healthcare systems and individual physicians. Although our understanding of physician burnout has advanced considerably in recent years, many gaps in our knowledge remain. Longitudinal studies of burnout's effects and the impact of interventions on both burnout and its effects are needed, as are studies of effective solutions implemented in combination. For medicine to fulfil its mission for patients and for public health, all stakeholders in healthcare delivery must work together to develop and implement effective remedies for physician burnout.
1,255 citations
TL;DR: Evidence from this meta-analysis suggests that recent intervention programs for burnout in physicians were associated with small benefits that may be boosted by adoption of organization-directed approaches, providing support for the view that burnout is a problem of the whole health care organization, rather than individuals.
Abstract: Importance Burnout is prevalent in physicians and can have a negative influence on performance, career continuation, and patient care. Existing evidence does not allow clear recommendations for the management of burnout in physicians. Objective To evaluate the effectiveness of interventions to reduce burnout in physicians and whether different types of interventions (physician-directed or organization-directed interventions), physician characteristics (length of experience), and health care setting characteristics (primary or secondary care) were associated with improved effects. Data Sources MEDLINE, Embase, PsycINFO, CINAHL, and Cochrane Register of Controlled Trials were searched from inception to May 31, 2016. The reference lists of eligible studies and other relevant systematic reviews were hand searched. Study Selection Randomized clinical trials and controlled before-after studies of interventions targeting burnout in physicians. Data Extraction and Synthesis Two independent reviewers extracted data and assessed the risk of bias. The main meta-analysis was followed by a number of prespecified subgroup and sensitivity analyses. All analyses were performed using random-effects models and heterogeneity was quantified. Main Outcomes and Measures The core outcome was burnout scores focused on emotional exhaustion, reported as standardized mean differences and their 95% confidence intervals. Results Twenty independent comparisons from 19 studies were included in the meta-analysis (n = 1550 physicians; mean [SD] age, 40.3 [9.5] years; 49% male). Interventions were associated with small significant reductions in burnout (standardized mean difference [SMD] = −0.29; 95% CI, −0.42 to −0.16; equal to a drop of 3 points on the emotional exhaustion domain of the Maslach Burnout Inventory above change in the controls). Subgroup analyses suggested significantly improved effects for organization-directed interventions (SMD = −0.45; 95% CI, −0.62 to −0.28) compared with physician-directed interventions (SMD = −0.18; 95% CI, −0.32 to −0.03). Interventions delivered in experienced physicians and in primary care were associated with higher effects compared with interventions delivered in inexperienced physicians and in secondary care, but these differences were not significant. The results were not influenced by the risk of bias ratings. Conclusions and Relevance Evidence from this meta-analysis suggests that recent intervention programs for burnout in physicians were associated with small benefits that may be boosted by adoption of organization-directed approaches. This finding provides support for the view that burnout is a problem of the whole health care organization, rather than individuals.
855 citations
TL;DR: This meta-analysis provides evidence that physician burnout may jeopardize patient care; reversal of this risk has to be viewed as a fundamental health care policy goal across the globe.
Abstract: Importance Physician burnout has taken the form of an epidemic that may affect core domains of health care delivery, including patient safety, quality of care, and patient satisfaction However, this evidence has not been systematically quantified Objective To examine whether physician burnout is associated with an increased risk of patient safety incidents, suboptimal care outcomes due to low professionalism, and lower patient satisfaction Data Sources MEDLINE, EMBASE, PsycInfo, and CINAHL databases were searched until October 22, 2017, using combinations of the key termsphysicians,burnout, andpatient care Detailed standardized searches with no language restriction were undertaken The reference lists of eligible studies and other relevant systematic reviews were hand-searched Study Selection Quantitative observational studies Data Extraction and Synthesis Two independent reviewers were involved The main meta-analysis was followed by subgroup and sensitivity analyses All analyses were performed using random-effects models Formal tests for heterogeneity (I2) and publication bias were performed Main Outcomes and Measures The core outcomes were the quantitative associations between burnout and patient safety, professionalism, and patient satisfaction reported as odds ratios (ORs) with their 95% CIs Results Of the 5234 records identified, 47 studies on 42 473 physicians (25 059 [590%] men; median age, 38 years [range, 27-53 years]) were included in the meta-analysis Physician burnout was associated with an increased risk of patient safety incidents (OR, 196; 95% CI, 159-240), poorer quality of care due to low professionalism (OR, 231; 95% CI, 187-285), and reduced patient satisfaction (OR, 228; 95% CI, 142-368) The heterogeneity was high and the study quality was low to moderate The links between burnout and low professionalism were larger in residents and early-career (≤5 years post residency) physicians compared with middle- and late-career physicians (CohenQ = 727;P = 003) The reporting method of patient safety incidents and professionalism (physician-reported vs system-recorded) significantly influenced the main results (CohenQ = 814;P = 007) Conclusions and Relevance This meta-analysis provides evidence that physician burnout may jeopardize patient care; reversal of this risk has to be viewed as a fundamental health care policy goal across the globe Health care organizations are encouraged to invest in efforts to improve physician wellness, particularly for early-career physicians The methods of recording patient care quality and safety outcomes require improvements to concisely capture the outcome of burnout on the performance of health care organizations
694 citations
05 Jul 2017
TL;DR: This research presents a state-of-the-art virtual reality simulation system that automates the very labor-intensive and therefore time-heavy and expensive and expensive process of manually cataloging and cataloging individual patients' medical histories and providing real-time information about their medical needs.
Abstract: Lotte N. Dyrbye, MD, MHPE, Mayo Clinic; Tait D. Shanafelt, MD, Mayo Clinic; Christine A. Sinsky, MD, American Medical Association; Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, American Nurses Association; Jay Bhatt, DO, MPH, MPA, American Hospital Association; Alexander Ommaya, DSc, Association of American Medical Colleges; Colin P. West, MD, PhD, Mayo Clinic; David Meyers, MD, Agency for Healthcare Research and Quality
458 citations
Cites background from "Physician Satisfaction and Burnout ..."
..., emergency medicine, general internal medicine, neurology) in comparison with other specialties [1,2,27,35,55,57,58,67], suggesting there is something unique to the work lives in these specialties that contributes to increased risk....
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...Multivariate analyses of data from cross-sectional studies of physicians have reported independent relationships between burnout and incentive pay (130 percent increased odds versus other salary models), career stage (25 percent more likely among midcareer physicians than early or late career), career fit (275 percent more likely among physicians who spend less than 20 percent of their work effort on the activity they find most personally meaningful), and use of computerized physician order entry (29 percent more likely among physicians who enter orders into a computer) [35,57,58]....
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...proximately 20 percent higher odds for burnout independent of specialty, work hours, incentive pay, and a variety of other factors [2,35,55,58]....
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...Other studies support this relationship between burnout and leaving the clinical practice [27,35,36]....
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References
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Book•
01 Jan 1959
TL;DR: Erikson as mentioned in this paper collected three early papers that-along with Childhood and Society-many consider to be the best introduction to Erikson's theories: "Ego Development and Historical Change", "Growth and Crises of the Health Personality" and "The Problem of Ego Identity".
Abstract: This book collects three early papers that-along with Childhood and Society-many consider the best introduction to Erikson's theories. "Ego Development and Historical Change" is a selection of extensive notes in which Erikson first undertook to relate to each other observations on groups studied on field trips and on children studied longitudinally and clinically. These notes are representative of the source material used for Childhood and Society. "Growth and Crises of the Health Personality" takes Erikson beyond adolescence, into the critical stages of the whole life cycle. In the third and last essay, Erikson deals with "The Problem of Ego Identity" successively from biographical, clinical, and social points of view-all dimensions later pursued separately in his work.
5,239 citations
Book•
01 Jan 1996
TL;DR: The full version of this book in pdf and epub formats can be found in this paper. But they do not store the book itself, but they give link to the site where you can download or read online.
Abstract: If you are looking for a book Maslach burnout inventory manual bwrbslk in pdf format then you've come to the right website. We presented the full version of this book in pdf and epub formats. You can read online Maslach burnout inventory manual bwrbslk or download to your computer. In addition to this book, on our site you can read the instructions and other art books online, or download them as well. We want to draw your attention that our site does not store the book itself, but we give link to the site where you can download or read online. So if you need to download Maslach burnout inventory manual bwrbslk then you've come to the right website. We will be happy if you come back to us again.
4,986 citations
TL;DR: This meta-analysis examined how demand and resource correlates and behavioral and attitudinal correlates were related to each of the 3 dimensions of job burnout, finding that emotional exhaustion was more strongly related to the demand correlates than to the resource correlates.
Abstract: This meta-analysis examined how demand and resource correlates and behavioral and attitudinal correlates were related to each of the 3 dimensions of job burnout. Both the demand and resource correlates were more strongly related to emotional exhaustion than to either depersonalization or personal accomplishment. Consistent with the conservation of resources theory of stress, emotional exhaustion was more strongly related to the demand correlates than to the resource correlates, suggesting that workers might have been sensitive to the possibility of resource loss. The 3 burnout dimensions were differentially related to turnover intentions, organizational commitment, and control coping. Implications for research and the amelioration of burnout are discussed.
3,036 citations
TL;DR: Burnout is more common among physicians than among other US workers, and Physicians in specialties at the front line of care access seem to be at greatest risk.
Abstract: Methods: We conducted a national study of burnout in a large sample of US physicians from all specialty disciplines using the American Medical Association Physician Masterfile and surveyed a probability-based sample of the general US population for comparison. Burnout was measured using validated instruments. Satisfaction with work-life balance was explored. Results: Of 27276 physicians who received an invitation to participate, 7288 (26.7%) completed surveys. When assessed using the Maslach Burnout Inventory, 45.8%ofphysiciansreportedatleast1symptomofburnout. Substantial differences in burnout were observed by specialty, with the highest rates among physicians at the front line of care access (family medicine, general internalmedicine,andemergencymedicine).Comparedwith a probability-based sample of 3442 working US adults, physicians were more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with worklife balance (40.2% vs 23.2%) (P.001 for both). Highest level of education completed also related to burnout in a pooled multivariate analysis adjusted for age, sex, relationship status, and hours worked per week. Comparedwithhighschoolgraduates,individualswithanMD or DO degree were at increased risk for burnout (odds ratio [OR], 1.36; P.001), whereas individuals with a bachelor’sdegree(OR,0.80;P=.048),master’sdegree(OR, 0.71;P=.01),orprofessionalordoctoraldegreeotherthan an MD or DO degree (OR, 0.64; P=.04) were at lower risk for burnout. Conclusions: Burnout is more common among physicians than among other US workers. Physicians in specialties at the front line of care access seem to be at greatest risk.
2,546 citations
TL;DR: The prevalence of burn out among internal medicine residents in a single university-based program is evaluated and the relationship of burnout to self-reported patient care practices is evaluated.
Abstract: In this study, burnout was common among resident physicians and was associated with self-reported suboptimal patient care practices.
1,958 citations