Physician Burnout

By September 27, 2018 Commentary

As we all know, doctors are under enormous pressure from a variety of forces–financial, including school debt and a desire to maintain a certain lifestyle, regulatory and payer micro-managing of “quality” of patient care, the increasing administrative challenges of being in medicine, and the expectations of their patients.  We would all like to imagine that our doctors nonetheless are unaffected by these factors as they treat us, but that may not be very realistic.  A couple of studies in the Journal of the American Medical Association present research regarding physician burnout.  (JAMA Article)  The primary article is a meta-review of research regarding the extent and correlates of physician job satisfaction.  182 studies from 45 countries were included in the review.  A common burnout inventory scale was the primary instrument used by most of the research.  And the prevalence of burnout varied from zero to 80%.  That is a pretty wide range.  There was wide diversity in how the studies defined and measured outcomes, and significant methodological issues with many of the studies, so that the authors of this meta-review concluded that no generalized finding could be made regarding burnout prevalence.

A separate study was a survey of second year residents regarding career choice and burnout.  Now lets start by recognizing that residency is a particularly intense and difficult time in a physician’s life, so it may not reflect longer term job satisfaction.  But that survey found that 45% of the residents reported symptoms of burnout and 14% expressed regret over career choice.  Residents in urology, neurology, general surgery and emergency medicine reported higher levels of regret and burnout symptoms, as did women.  Doctors and increasingly nurse practitioners are on the front lines of patient interaction and treatment.  It is important for the organizations employing them to recognize that it is a high-stress job and to be actively alert for signs of burnout, to have programs to address the issues causing burnout and to ensure that job satisfaction issues don’t affect the quality or outcomes of patient care.  To do all this will require better tools and methods than we apparently currently have to identify clinicians who are truly stressed.

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