Corrigendum to Physician Task Load and the Risk of Burnout Among US Physicians in a National Survey [The Joint Commission Journal on Quality and Patient Safety 47, 2 (2021) 76-85

The Wicked Problem of Physician Well-Being.

Physician Task Load and the Risk of Burnout Among US Physicians in a National Survey

Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2023.

Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2020

ASTUDY OF US PHYSICIANS SHOWED that physicians in 1997 were less satisfied in every aspect of their professional life than those asked similar questions in 1986. They were dissatisfied with the time they have with individual patients and their lack of incentives for high-quality care. Similarly, a 1998 study revealed that two thirds of Canadian physicians have a workload they consider too heavy, and more than half stated their family and personal lives have suffered because they chose medicine as a profession. Dissatisfaction has been documented in several diverse physician groups, including primary care, surgery, infectious disease specialists, and anesthesiologists. The leaders of medical school departments are exposed to similar pressures. These recent articles highlight the growing discontent of physicians with the increasing complexities of the practice of medicine. Burnout, a term that has moved from colloquial speech into the social and psychological vernacular, describes this phenomenon. There is a growing awareness within medicine that physicians and other health care professionals are at risk for burnout, which threatens the sustainability of the health care enterprise. Preventing burnout by promoting the wellbeing of physicians has been the focus of several recent initiatives. The Western Journal of Medicine devoted its entire January 2001 issue to offer guidance in living positive and healthy lives. In addition, the Joint Commission on Accreditation of Healthcare Organizations has mandated that as of January 1, 2001, all hospitals have a process to address physician well-being, separate from disciplinary processes. We review the definition of burnout and its sources; examine the interaction of physician personality factors and the unique stressors they encounter in the workplace and at home; and highlight current resources for preventing burnout and promoting wellbeing in physicians and within their organizations.

Burnout in Cardiac Anesthesiologists: Results From a National Survey in Italy

The prevalence of burnout and depression in anesthesiology residents has not been determined. It is also unknown whether anesthesiology resident burnout/depression may affect patient care and safety. The primary objective of this study was to determine the prevalence of burnout and depression in anesthesiology residents in the United States. We hypothesized that residents at high risk of burnout and/or depression would report more medical errors as well as a lower rate of following principles identified as the best practice of anesthesiology. A cross-sectional survey was sent to 2773 anesthesiology residents in the United States. The questionnaire was divided into 5 parts examining trainees' demographic factors, burnout (Maslach Burnout Inventory), depression (Harvard depression scale), 10 questions designed to evaluate best practice of anesthesiology, and 7 questions evaluating self-reported errors. Best practices and self-reported error rates were compared among subjects with a high risk of burnout only, high risk of depression only, high risk of burnout and depression, and low risk of burnout and depression. Pairwise comparisons were considered significant at P < 0.004 and confidence intervals (CIs) reported at 99.6%. There were 1508 (54%) resident responds. High burnout risk was found in 41% (575 of 1417) of respondents. Working >70 hours per week, having >5 drinks per week, and female gender were associated with increased burnout risk. Twenty-two percent (298 of 1384) screened positive for depression. Working >70 hours of work per week, smoking, female gender, and having >5 drinks per week were associated with increased depression risk. Two hundred forty (17%) respondents scored at high risk of burnout and depression, 321 (23%) at high risk of burnout, 58 (4%) at high risk of depression only, and 764 (56%) at low risk of burnout or depression. Median best practice scores (maximum = 30) for residents at high risk of burnout (difference -2; 99.6% CI, -1 to -2; P < 0.001) or high risk of burnout and depression (difference -4; 99.6% CI, -3 to -6; P < 0.001) were lower than scores of residents at low risk for burnout or depression. Thirty-three percent of respondents with high burnout and depression risk reported multiple medication errors in the last year compared with 0.7% of the lower-risk responders (P < 0.001). Burnout, depression, and suicidal ideation are very prevalent in anesthesiology residents. In addition to effects on the health of anesthesiology trainees, burnout and depression may also affect patient care and safety.

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We sought to assess physician knowledge/beliefs, self-efficacy, and experience/practice patterns surrounding smoking cessation and electronic cigarettes. An eight-page survey sent via US Postal service. The initial invitation included a $10 cash incentive and up to three invitations were sent. Fifteen hundred US physicians were identified with equal representation from primary care physicians (internal medicine and family practice), surgical care physicians (general surgeons and anesthesiologists), and pulmonologists. Two hundred fourteen were not included in the analysis (183 non-deliverable, one deceased, 30 not practicing). 561/1286 (44%) remaining surveys were returned for analysis. Greater than 90% agreed that advising and assisting with smoking cessation is their responsibility; 86% advise and 65% assist their patients with smoking cessation more than 75% of the time. Approximately two-thirds of respondents report that their patients ask them about electronic cigarettes at least some of the time (≥25%); 58.4% report that they ask their patients about electronic cigarette use at least some of the time. Overall, 37.9% have at some point recommended electronic cigarettes to their patients that smoke, with 11.5% reporting recommending them at least 25% of the time. Surgical care providers appear less confident and less self-efficacious with smoking cessation, as well as with electronic cigarettes and appear less likely to endorse use of electronic cigarettes. US physicians are frequently discussing electronic cigarettes in a clinical context and a substantial proportion of US physicians have recommended electronic cigarettes to their patients. This study documents several important previously poorly characterized aspects of the role of electronic cigarettes in clinical care. The majority of US physicians are discussing electronic cigarettes in clinical contexts and a substantial proportion of US physicians have recommended electronic cigarettes to their patients. The extent of physician engagement on the topic of electronic cigarettes should be met with increased efforts to better characterize electronic cigarettes' appropriate role in smoking cessation and reduction.

1. Paria M. Wilson, MD, MEd* 2. Maneesh Batra, MD, MPH† 3. Kathi J. Kemper, MD, MPH‡ 4. John D. Mahan, MD‡,§ 5. Betty B. Staples, MD¶ 6. Janet R. Serwint, MD** 1. *Division of Emergency Medicine, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA 2. †Department of Pediatrics, Division of Neonatology, Seattle Children’s Hospital and the University of Washington, Seattle, WA 3. ‡The Ohio State University, Columbus, OH 4. §Department of Pediatrics, Division of Nephrology, Nationwide Children’s Hospital and The Ohio State University, Columbus, OH 5. ¶Department of Pediatrics, Duke University Medical Center, Durham, NC 6. **Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD * Abbreviations: EHR: : electronic health record OR: : odds ratio SMART: : Stress Management and Resiliency Training > Every once in a while in Pediatrics in Review , Editors-in-Chief Bob Haggerty and Larry Nazarian would advise readers to care for themselves. They offered commentaries on such subjects as how to transition to retirement or part-time practice, taking time to reflect on the joy of pediatrics, and stepping out of the office to partake in community events. In the spirit of Dr Haggerty’s and Dr Nazarian’s hope that readers take care of themselves, Pediatrics in Review offers the following review. > > —JZ Clinicians and trainee physicians should be aware of the components of wellness and how to foster them in their daily practice. Interventions have been aimed at the individual and organizational levels. After …

Moral distress (MD) is the result of barriers or constraints that prevent providers from carrying out what they believe to be ethically appropriate care. This study was initiated to explore associations between MD, burnout, and the organizational climate (OC) for oncology physician assistants (PAs). A national survey of oncology PAs was conducted to explore the associations between MD, OC, and burnout. The Nurse Practitioner-Primary Care OC Questionnaire was revised for oncology PAs to assess OC for PA practice. MD and burnout were assessed using the Measure of MD-Healthcare Professionals (MMD-HP) and the Maslach Burnout Inventory. One hundred forty-six oncology PAs are included in the analysis. PAs were mostly female (90%), White/Caucasian (84%), married/partnered (78%), and in medical oncology (73%), with mean age 41.0 years. The mean MMD-HP score for oncology PAs was 71.5 and there was no difference in MD scores on the basis of oncology subspecialty, practice setting, practice type, or hours worked per week. PAs currently considering leaving their position because of MD had significantly higher mean scores on the MMD-HP compared with those not considering leaving their position (108.2 v 64.8; P = .001). PAs with burnout also had significantly higher mean scores for MD compared with PAs without burnout (97.6 v 54.3; P < .001). A negative relationship between OC for PA practice and MD was only found for the PA-administration relations subscale, whereas all subscales were negatively associated with burnout. This study demonstrates that the risk of professional burnout increases significantly with increasing levels of MD. Additional research exploring the relationship between MD and burnout is needed.

To develop a benchmark measure of US physicians' level of knowledge and extent of use of pharmacogenomic testing, we conducted an anonymous, cross-sectional, fax-based, national survey. Of 397,832 physicians receiving the survey questionnaire, 10,303 (3%) completed and returned it; the respondents were representative of the overall US physician population. The factors associated with the decision to test were evaluated using χ(2) and multivariate logistic regression. Overall, 97.6% of responding physicians agreed that genetic variations may influence drug response, but only 10.3% felt adequately informed about pharmacogenomic testing. Only 12.9% of physicians had ordered a test in the previous 6 months, and 26.4% anticipated ordering a test in the next 6 months. Early and future adopters of testing were more likely to have received training in pharmacogenomics, but only 29.0% of physicians overall had received any education in the field. Our findings highlight the need for more effective physician education on the clinical value, availability, and interpretation of pharmacogenomic tests.

Regulatory agencies and policy makers increasingly recognize real-world evidence (RWE) as a valuable complement to randomized controlled trials (RCTs) in oncology, yet data on how US physicians who treat cancer use and perceive RWE remain limited. The study aimed to assess attitudes toward RWE among US physicians who treat cancer, including their confidence in interpreting it and reliance across clinicaldecision contexts. A cross-sectional national survey was administered in November 2024 to licensed US physicians who treat cancer, recruited from the American Society of Clinical Oncology (ASCO) member directory, using a random sample stratified by state population. Inclusion criteria were active US medical licensure and current involvement in oncology patient care. The survey instrument included sections on demographics and practice characteristics; RWE familiarity and usage frequency; comparative reliance on RWE versus RCTs in treatment selection, dosing, and outcome prediction (scales ranging from 0 to 10: 0 = complete reliance on RCT data, 10 = complete reliance on RWE); perceived barriers to adoption (4-point scale); and potential facilitators (4-point scale). Categorical data were summarized as counts and percentages, and continuous variables were summarized as means and standard deviations (SD). Chi-squared tests were used to compare categorical variables across groups, paired t tests were used to assess differences in mean reliance scores, and Spearman's rho was used to evaluate correlations. Statistical significance was set at p < 0.05. In total, 128 completed surveys were received. Overall, 94%of respondents (n = 120) were at least "somewhat familiar" with RWE, 14% (n = 18) used it "often," and 3% (n = 4) reported daily use. 49% (n = 63) felt confident interpreting RWE studies, with late-career physicians (> 20 years of experience) less confident than their early and mid-career peers. Reliance on RWE was lower for treatment selection (mean 3.0, SD 1.7) than for dosing (mean 3.7, SD 2.0) or outcome prediction (mean 3.8, SD 2.0) (p < 0.001). Top barriers included reconciling conflicting RWE versus RCT data, data completeness, and bias. Key facilitators included improved analytical standards, guideline integration, and additional training. While awareness of RWE is high among US physicians who treat cancer, they apply it selectively on the basis of clinical context, showing notably lower reliance for treatment selection. Addressing concerns about methodological rigor, data quality, and interpretive skills may strengthen RWE's integration into oncology care.

Unfinished nursing care in intensive care units and the mediating role of the association between nurse working environment, and quality of care and nurses’ wellbeing

Association of burnout and intention-to-leave the profession with work environment: A nationwide cross-sectional study among Belgian intensive care nurses after two years of pandemic