3 big factors that drive resident physician burnout

Jennifer Lubell , Contributing News Writer

After surveying more than 20,000 physicians and other health professionals across the country, Mark Linzer, MD, has learned a great deal about the drivers of burnout—and possible remedies. 

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“Feeling valued was a big mitigator, with burnout rates 30% lower if present. Teamwork was also a big mitigator, while work overload and fast-paced environments were key aggravators,” said Dr. Linzer. He was lead author of the study reporting on these findings that was published in JAMA Health Forum™.

Burnout is real. Rates skyrocketed at the end of 2021 to over 60%, noted Dr. Linzer, who is vice-chief of medicine at Hennepin Healthcare in Minneapolis and also directs the Institute for Professional Worklife there. Making changes at the residency training level is an important strategy for tackling burnout, he advised.

Research by Dr. Linzer and colleagues has revealed “several strong correlates of work conditions with resident burnout, which means there are many ways that programs can address this,” he said. Work-life factors such as teamwork, control of workload, fast-paced, chaotic environments, and time pressure can all affect burnout.

Researchers also identified three resident-specific items contributing to burnout:

  • Sleep impairment.
  • Program recognition of the resident.
  • Interruptions.

“One of our key findings is that work overload and sleep matter, even in the era of duty-hour restrictions,” noted Dr. Linzer.

Residency programs that take physicians’ well-being seriously are more attractive to residency applicants, he stressed. In an episode of “AMA Update,” Dr. Linzer discussed the innovative tool he uses to analyze resident burnout and specific actions residency program and health system leaders can take to increase well-being.

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Dr. Linzer developed the Mini Z measurement instrument, a tool that efficiently measures burnout. It takes two minutes to complete, reducing a six-page survey to a single page.

“Recent studies show it performs very well in measuring in terms of reliability and validity,” said Dr. Linzer. Mini Z versions exist for physicians, residents, nurses, leaders and other clinical staff.

Mini Z core items include three outcomes—satisfaction, stress and burnout, and seven predictors, including the main burnout causes of time pressure. There’s also the three C’s—control, chaos and culture—such as values alignment with leaders.

Translated into several languages, it’s used throughout the world.

Reducing physician burnout is a critical component of the AMA Recovery Plan for America’s Physicians.

Far too many American physicians experience burnout. That's why the AMA develops resources that prioritize well-being and highlight workflow changes so physicians can focus on what matters—patient care.

Learn more with the AMA STEPS Forward® toolkit, “Resident and Fellow Burnout: Create a Holistic, Supportive Culture of Well-Being.” 

We need your help

Become a member and help the AMA tackle the key causes of burnout to provide relief for physicians.

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Evidence-based program interventions usually work best at mitigating and prevent resident physician burnout, advised Dr. Linzer. These may include jeopardy coverage for essential life events, a newsletter celebrating resident achievements, removal of after-hours consult pager call, an extra day off for senior residents on the wards, and care packages distributed through night teams. 

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Illustration of resident looking at a diagnostic image

“Faculty being on the alert for adverse work environments, such as excess admissions and inability for residents to unplug from the work environment and head home, or in people being distanced on rounds—so they’re not really connecting—might prompt faculty to go deeper and discuss with the resident or program director if they can help,” Dr. Linzer said.

Residency program leaders should also involve residents in data review and interventions. “This is a team effort,” he said. “Let the team guide what needs to be changed and where to go and then let you know if you got there.”

AMA Update” covers health care topics affecting the lives of physicians and patients. Hear from physicians and experts on public health, advocacy issues, scope of practice and more—because who’s doing the talking matters. You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version, which also features educational presentations and in-depth discussions.