Physician burnout is a significant issue affecting the standard and availability of healthcare within the US. The rising rate of this problem spurred a recent study aimed toward identifying its roots. The study was published online in JAMA Network Open.

Study: Patterns in Physician Burnout in a Stable-Linked Cohort. Image Credit: Ground Picture/Shutterstock.com

Introduction

Physician burnout refers to “a state of emotional, physical, and mental exhaustion brought on by prolonged stress within the workplace.” Multiple aspects may result in burnout, including lack of independence on the workplace, overwork, and lack of time for non-professional activities.

The importance of burnout within the medical field lies within the potential for errors in diagnosis and treatment, the lower patient satisfaction rating, and the increased odds of absenteeism. It may lead to fewer physicians being available for healthcare, which can impact the neediest areas and essentially the most in-demand specialties first.

This might cause patient waiting times for consults to go up, decreasing access to healthcare and reducing the standard of care as well.

The Maslach Burnout Inventory (MBI) was used to evaluate physician burnout. The MBI measures physician burnout using three subscales, namely, Exhaustion, Cynicism, and Skilled Efficacy.

Surprisingly, over 45% of physicians reported a number of burnout symptoms using this scale. Some researchers reported a steep rise in burnout rates with the onset of the coronavirus disease 2019 (COVID-19) pandemic, especially because the second yr ran its course.

The foremost features observed amongst physicians right now were depersonalization and emotional exhaustion. Since many reasons may contribute to bias within the estimation of the national burnout rate amongst physicians, the present study sought to compensate for these aspects and achieve a more accurate figure.

A few of these confounding aspects include the indisputable fact that physicians with more experience are likely to feel less burned out; those with more burnout are likely to leave the medical field. Furthermore, the response rate in burnout surveys is usually low. The present study used a high-response survey, linking responses by participants through all three surveys to beat sources of bias.

What did the study show?

The study comprised three surveys covering almost 1400 physicians belonging to the Massachusetts General Physicians Organization (MGPO). This number represents 73% of the number who originally enrolled in the primary survey. The respondents belonged to either sex in equal proportions, but barely over two-thirds were White. About 13% were Hispanic.

All three surveys had a high response rate, linked to the numerous financial incentive of $850. While the primary and second surveys in 2017 and 2019 obtained a 93% response rate each, the last one in 2021 had a 92% response.

The survey checked out 4 areas: profession and compensation satisfaction, well-being, administrative workload, and leadership and variety content. If two of the three MBI subscales showed a high rating, burnout was determined to be present; otherwise, it was absent. Nevertheless, a separate evaluation also examined the measures in a continuous fashion.

Over the three surveys, a couple of in 4 physicians were burned out, with no change observed within the state of burnout. Similarly, a couple of in three physicians didn’t experience burnout at any stage.

In other words, greater than 60% didn’t change their burnout rating over the three surveys, but over 30% showed a rise of their already high scores.

Over a 3rd of the physicians had been in practice for 11-20 years, reflecting considerable experience. On this group, the speed of burnout went down barely from about 44% in 2017 to 42% in 2019. Nevertheless, it then shot as much as 50% in 2021. In comparison with less experienced physicians, the percentages of burnout in those in practice for 30 or more years were only a fifth of those with lower than a decade of experience.

The entire cohort showed the identical trend, with the burnout risk doubling in 2021, whereas it remained stable over the 2 previous surveys. Women on this field were at 50% higher risk for burnout than men. Again, those working in primary care were almost 3 times more more likely to burn out than physicians in internal medicine.

The scientists also found that individual variation is major in determining burnout. Through the same study period, for example, over 60% of physicians reported exhaustion at the identical level in all surveys, whether high or low. This was true for all three subscales.

Physicians with less burnout spent less time on non-physician (administrative) tasks, below 1 / 4 of their time vs over 30% within the group with high burnout. They were more satisfied with their job and remuneration and had worked for more years. Perhaps it takes time to succeed in a level of practice where satisfaction outweighs the stress.

What are the implications?

The increasing burnout rate amongst US physicians is a cogent problem, given the rising rates of chronic health conditions requiring specialized and long-term healthcare. “This pattern represents a possible threat to the power of the US health care system to look after patients and wishes urgent solutions.”