Abstract
BackgroundAwareness of the economic cost of physician attrition due to burnout in academic medical centers may help motivate organizational level efforts to improve physician wellbeing and reduce turnover. Our objectives are: 1) to use a recent longitudinal data as a case example to examine the associations between physician self-reported burnout, intent to leave (ITL) and actual turnover within two years, and 2) to estimate the cost of physician turnover attributable to burnout.MethodsWe used de-identified data from 472 physicians who completed a quality improvement survey conducted in 2013 at two Stanford University affiliated hospitals to assess physician wellness. To maintain the confidentially of survey responders, potentially identifiable demographic variables were not used in this analysis. A third party custodian of the data compiled turnover data in 2015 using medical staff roster. We used logistic regression to adjust for potentially confounding factors.ResultsAt baseline, 26% of physicians reported experiencing burnout and 28% reported ITL within the next 2 years. Two years later, 13% of surveyed physicians had actually left. Those who reported ITL were more than three times as likely to have left. Physicians who reported experiencing burnout were more than twice as likely to have left the institution within the two-year period (Relative Risk (RR) = 2.1; 95% CI = 1.3–3.3). After adjusting for surgical specialty, work hour categories, sleep-related impairment, anxiety, and depression in a logistic regression model, physicians who experienced burnout in 2013 had 168% higher odds (Odds Ratio = 2.68, 95% CI: 1.34–5.38) of leaving Stanford by 2015 compared to those who did not experience burnout. The estimated two-year recruitment cost incurred due to departure attributable to burnout was between $15,544,000 and $55,506,000. Risk of ITL attributable to burnout was 3.7 times risk of actual turnover attributable to burnout.ConclusionsInstitutions interested in the economic cost of turnover attributable to burnout can readily calculate this parameter using survey data linked to a subsequent indicator of departure from the institution. ITL data in cross-sectional studies can also be used with an adjustment factor to correct for overestimation of risk of intent to leave attributable to burnout.
Highlights
Awareness of the economic cost of physician attrition due to burnout in academic medical centers may help motivate organizational level efforts to improve physician wellbeing and reduce turnover
Many reports have demonstrated associations between burnout and intent to leave, [7, 14,15,16,17,18,19,20,21,22,23] only one study has examined the association between physician burnout and actual subsequent turnover in an academic medical center in the US [6]
The primary objective of our study is to examine the associations of physician self-reported burnout with intent to leave and actual turnover, using a recent longitudinal data case example, both before and after adjusting for anxiety and depression
Summary
Awareness of the economic cost of physician attrition due to burnout in academic medical centers may help motivate organizational level efforts to improve physician wellbeing and reduce turnover. Accurate information on the economic cost of physician burnout to health care organizations may help motivate systematic organizational level efforts to improve physician wellbeing [4]. Many reports have demonstrated associations between burnout and intent to leave, [7, 14,15,16,17,18,19,20,21,22,23] only one study has examined the association between physician burnout and actual subsequent turnover in an academic medical center in the US [6]. In terms of estimated cost of physician burnout, there is only one study that has estimated the cost of departure, based on intent to leave data, attributable to burnout in Canada in 2014 [17]
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