Abstract
BackgroundHealth care organizations globally realize the need to address physician burnout due to its close linkages with quality of care, retention and migration. The many functions of health human resources include identifying and managing burnout risk factors for health professionals, while also promoting effective coping. Our study of physician burnout aims to show: (1) which correlates are most strongly associated with emotional exhaustion (EE) and depersonalization (DP), and (2) whether the associations vary across regions and specialties.MethodsMeta-analysis allowed us to examine a diverse range of correlates. Our search yielded 65 samples of physicians from various regions and specialties.ResultsEE was negatively associated with autonomy, positive work attitudes, and quality and safety culture. It was positively associated with workload, constraining organizational structure, incivility/conflicts/violence, low quality and safety standards, negative work attitudes, work-life conflict, and contributors to poor mental health. We found a similar but weaker pattern of associations for DP.Physicians in the Americas experienced lower EE levels than physicians in Europe when quality and safety culture and career development opportunities were both strong, and when they used problem-focused coping. The former experienced higher EE levels when work-life conflict was strong and they used ineffective coping. Physicians in Europe experienced lower EE levels than physicians in the Americas with positive work attitudes. We found a similar but weaker pattern of associations for DP.Outpatient specialties experienced higher EE levels than inpatient specialties when organization structures were constraining and contributors to poor mental health were present. The former experienced lower EE levels when autonomy was present. Inpatient specialties experienced lower EE levels than outpatient specialties with positive work attitudes. As above, we found a similar but weaker pattern of associations for DP.ConclusionsAlthough we could not infer causality, our findings suggest: (1) that EE represents the core burnout dimension; (2) that certain individual and organizational-level correlates are associated with reduced physician burnout; (3) the benefits of directing resources where they are most needed to physicians of different regions and specialties; and (4) a call for research to link physician burnout with performance.
Highlights
IntroductionOur study of physician burnout aims to show: (1) which correlates are most strongly associated with emotional exhaustion (EE) and depersonalization (DP), and (2) whether the associations vary across regions and specialties
Health care organizations globally realize the need to address physician burnout due to its close linkages with quality of care, retention and migration
Our study found that reducing the individual and organizational-level risk factors is associated with decreased burnout
Summary
Our study of physician burnout aims to show: (1) which correlates are most strongly associated with emotional exhaustion (EE) and depersonalization (DP), and (2) whether the associations vary across regions and specialties. A 2008 World Health Organization (WHO) report found that the major factors for turnover and migration were poor or environmental burnout risk factors, while simultaneously promoting effective coping [3,4,5]. Physician burnout is characterized primarily by a depletion of mental energy, known as emotional exhaustion (EE). With such depletion, providers feel unable to give of themselves, which leads to cynical attitudes and detached feelings toward patients, known as depersonalization (DP). Our study will focus on the EE and DP dimensions only
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