Although rates of burnout and satisfaction with work-life integration improved among US physicians between 2014 and 2017, they still face an increased risk for burnout compared with workers in other fields, according to a study published in Mayo Clinic Proceedings.
Starting in 2011, investigators surveyed physicians and workers in the United States every 3 years to chronicle burnout rates and work-life integration satisfaction. In the initial 2011 survey, 45% of physicians had at least 1 manifestation of professional burnout. The burnout-associated problems were more common in physicians than other types of workers even after adjusting for confounders such as hours worked per week, and these gaps only widened by 2014. Recognizing that physician distress caused by burnout could adversely affect quality of care, the American Medical Association took steps toward ameliorating this in 2012, and after commissioning a RAND report in 2013, convened numerous meetings with experts. This led to the creation of various online resources and modules aimed at addressing physician burnout.
Between October 2017 and March 2018, surveys of physicians and workers were repeated using methods similar to those used in the studies done in 2011 and 2014. To evaluate response bias, a sample of nonresponders was then contacted for a secondary study with intensive follow up. O f a total 30,456 physicians invited to participate, 17.1% (n=5197) completed the surveys, and 52.1% of the 476 nonresponder physicians responded to the secondary survey. No significant differences in burnout scores were seen when comparing responders and nonresponders (P =.66).
According to assessments using the Maslach Burnout Inventory, rates of burnout improved between 2014 and 2017, with 54.4% (3680 of 6767) of physicians reporting at least 1 burnout symptom in 2014 and 43.9% (2147 of 4893) reporting at least 1 symptom in 2017 (P <.001). However, the current rates are only slightly better than those in 2011, when 45.5% (3310 of 7227) of physicians reported at least 1 burnout symptom (P =.04). Satisfaction with work-life integration in 2017 was more favorable than in 2014 (42.7% [2056 of 4809] vs 40.9% [2718 of 6651]; P <.001) but less favorable than the work-life integration satisfaction seen in 2011 (48.5% [3512 of 7244]; P <.001). From multivariate analyses adjusted for sex, age, hours/week worked, and relationship status, the researchers determined that physicians were at a higher risk for burnout (odds ratio [OR], 1.39; 95% CI, 1.26-1.54; P <.001) and were less likely to feel satisfied with work-life integration ( OR 0.77; 95% CI, 0.70-0.85; P <.001) compared with other working US adults in 2017.
Limitations to this study include a potential for response bias, an inability to assess changes in burnout and work-life balance over time in individual physicians, and an inability to determine causality or direction of effect. However, study investigators concluded, “Burnout and satisfaction with [work-life balance] among US physicians improved between 2014 and 2017. This trend is reason for optimism and suggests that progress is both possible and under way. Despite this improvement, symptoms of burnout among physicians continue to be prevalent and markedly higher than seen in the general US working population. Given the evidence that burnout impacts patient satisfaction, access, quality of care, and costs, continued efforts to make progress are needed.”
Shanafelt TD, West CP, Sinsky C, et al. Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2017. Mayo Clin Proc. 2019;94:1681-1694.