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26-08-2012 | Article

Nearly half of MDs report burnout symptoms


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medwireNews: Physician, heal thyself, because thou art at a high risk for career burnout, results of a nationwide survey suggest.

Of 7288 physicians who responded to a survey, nearly half (45.8%) reported at least one symptom of burnout, such as emotional exhaustion, low sense of personal accomplishment, or depersonalization (detachment), report Tait D Shanafelt (Mayo Clinic, Rochester, Minnesota) and colleagues online in Archives of Internal Medicine.

Emergency department physicians, general internists, family medicine practitioners, and neurologists were most likely to report burnout symptoms, whereas pathologists, dermatologists, general pediatricians, and preventive medicine specialists tended to be the least affected by the scope and pace of their work, the investigators report.

"Collectively, the findings of this national study indicate that (1) the prevalence of burnout among US physicians is at an alarming level, (2) physicians in specialties at the front line of care access (emergency medicine, general internal medicine and family medicine) are at greatest risk, (3) physicians work longer hours and have greater struggles with work-life integration than other US workers, and (4) after adjusting for hours worked per week, higher levels of education and professional degrees seem to reduce the risk for burnout in fields outside of medicine, whereas a degree in medicine (MD, or DO) increases the risk," they write.

Shanafelt and team invited 27,276 US physicians from all specialties to participate in a survey measuring burnout using a truncated form of the validated Maslach Burnout Inventory (MBI) and the two-item Primary Care Evaluation of Mental Disorders, a standardized clinical assessment for depression. In all, 7288 (26.7%) completed the survey.

When they compared their physician sample with a probability-based sample of 3442 working US adults, the authors found that physicians were significantly more likely to have symptoms of burnout than controls (37.9% vs 27.8%) and more likely to report dissatisfaction with their work-life balance (40.2% vs 23.2%).

In a pooled multivariate analysis adjusted for age, sex, hours worked per week and relationship status, Shanafelt et al found individuals with an MD or DO degree had more than a one-third increase in risk for burnout (odds ratio [OR] =1.36). In contrast, educated individuals with either a bachelor's degree (OR=0.80), master's degree (OR=0.71) or non-MD/DO professional or doctoral degree (OR=0.64) were at lower risk (all comparisons statistically significant).

"The fact that almost one in two US physicians has symptoms of burnout implies that the origins of this problem are rooted in the environment and care delivery system rather than in the personal characteristics of a few susceptible individuals. Policy makers and health care organizations must address the problem of physician burnout for the sake of physicians and their patients," the authors conclude.

By Neil Osterweil, medwireNews reporter