Workplace pressures tend to dominate the discussion on physician burnout, but for many doctors there are substantial risk factors at play even before they pick up their stethoscopes to start another day of practice.
Those factors are tied to gender, age and relationships. Research establishing those connections adds to the understanding of the burnout crisis threatening the well-being of patients and physicians, and the stability of the health care system.
Authors of a discussion paper published on the National Academy of Medicine website, Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care, looked at numerous studies on burnout and identified many factors driving the phenomenon among physicians.
The authors—including the AMA’s Vice President of Professional Satisfaction Christine A. Sinsky, MD, who is a general internist—listed 10 work-related factors associated with burnout, including private practice, incentive pay pressures and clerical burdens. It also reported on the current state of physician demographic characteristics that point to a higher risk for physician burnout.
These are four factors that are associated with and increased risk for physician burnout.
Female physicians, according to some studies, have 30-60 percent increased odds of experiencing burnout, according to several studies cited by the authors. However, the authors also noted that “gender is not consistently an independent predictor of burnout after adjusting for age and other factors.”
Physician burnout is defined by three elements—emotional exhaustion, depersonalization and a lost sense of personal accomplishment—but the discussion paper also addressed depression among female physicians. The authors noted that female doctors “are more likely to experience symptoms of depression than male physicians.”
However, the authors also stated that depression was “not more common among female physicians than other females in the general population.”
Younger physicians, defined as those doctors less than 55 years of age, are 200 percent more likely to experience symptoms of burnout compared with their older peers.
The physician parent of a child younger than 21 years old faces 54 percent increased odds of burnout.
A physician with a spouse or partner employed as a nonphysician health care provider has 23 percent increased odds of burnout.
Several of the workplace-related risk factors listed in the discussion paper also indicate a strong potential for overlap with a physician’s private or family life. They include night or weekend on call, performing work tasks at home, home-work conflicts, or working too many hours.
Systems solutions can help doctors
The principal focus of addressing the physician burnout crisis has been—and can be expected to remain—the implementation of improvements in the workplace. That’s the setting for the often-flawed processes, technologies and work cultures closely linked to burnout.
Most physicians now report some degree of burnout and the problem cuts across all demographic lines within the profession.
“The majority of burnout is related to systems factors,” said Dr. Sinsky. “The most effective ways to reduce burnout are through systems improvement.”
Progress in the workplace at the systems level can help with the personal factors noted in the report. Physicians who have optimized teamwork or have improved workflow “have been able to go home an hour or more earlier every night,” she added.
“Whether you are male or female, a parent or non-parent, that extra time can go a long way to restoring your sense of wellbeing,” said Dr. Sinsky.
Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand and reduce the challenges physicians face. By focusing on factors causing burnout at the system-level, the AMA assesses an organization’s well-being and offers guidance and targeted solutions to support physician well-being and satisfaction.
The AMA Ed Hub™—your center for personalized learning from sources you trust—offers CME on Creating the Organizational Foundation for Joy in Medicine™ using the STEPS Forward™ open-access platform that offers innovative strategies that allow physicians and their staff to thrive in the new health care environment. These toolkits can help you prevent physician burnout, create the organizational foundation for joy in medicine, create a strong team culture and improve practice efficiency.
