Abstract
BackgroundBurnout and intolerance of uncertainty have been linked to low job satisfaction and lower quality patient care. While resilience is related to these concepts, no study has examined these three concepts in a cohort of doctors. The objective of this study was to measure resilience, burnout, compassion satisfaction, personal meaning in patient care and intolerance of uncertainty in Australian general practice (GP) registrars.MethodsWe conducted a paper-based cross-sectional survey of GP registrars in Australia from June to July 2010, recruited from a newsletter item or registrar education events. Survey measures included the Resilience Scale-14, a single-item scale for burnout, Professional Quality of Life (ProQOL) scale, Personal Meaning in Patient Care scale, Intolerance of Uncertainty-12 scale, and Physician Response to Uncertainty scale.Results128 GP registrars responded (response rate 90%). Fourteen percent of registrars were found to be at risk of burnout using the single-item scale for burnout, but none met the criteria for burnout using the ProQOL scale. Secondary traumatic stress, general intolerance of uncertainty, anxiety due to clinical uncertainty and reluctance to disclose uncertainty to patients were associated with being at higher risk of burnout, but sex, age, practice location, training duration, years since graduation, and reluctance to disclose uncertainty to physicians were not.Only ten percent of registrars had high resilience scores. Resilience was positively associated with compassion satisfaction and personal meaning in patient care. Resilience was negatively associated with burnout, secondary traumatic stress, inhibitory anxiety, general intolerance to uncertainty, concern about bad outcomes and reluctance to disclose uncertainty to patients.ConclusionsGP registrars in this survey showed a lower level of burnout than in other recent surveys of the broader junior doctor population in both Australia and overseas. Resilience was also lower than might be expected of a satisfied and professionally successful cohort.
Highlights
Burnout and intolerance of uncertainty have been linked to low job satisfaction and lower quality patient care
Our survey found a lower prevalence of burnout in general practice (GP) registrars (14% using the single-item scale and none using the Professional Quality of Life (ProQOL) burnout subscale) than other recent surveys of the Australian junior doctor population (31 – 75%) [4,24,25]
Our study showed burnout in GP registrars is strongly linked with general intolerance of uncertainty
Summary
Burnout and intolerance of uncertainty have been linked to low job satisfaction and lower quality patient care. While resilience is related to these concepts, no study has examined these three concepts in a cohort of doctors. The objective of this study was to measure resilience, burnout, compassion satisfaction, personal meaning in patient care and intolerance of uncertainty in Australian general practice (GP) registrars. Higher intolerance of clinical uncertainty has been linked to burnout in one study of primary care physicians [6] and one study of emergency physicians [7] in the USA. General practitioners and other primary care practitioners who see a high proportion of undifferentiated illness are exposed to uncertainty in decision making. Doctors with higher anxiety about uncertainty tend to have higher costs of investigation and treatment [8]
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