Abstract
IntroductionBurnout is prevalent among emergency physicians and may cause physicians to consider leaving the practice of emergency medicine (EM). This study sought to determine whether there is a gender difference in reporting burnout and seriously considering leaving the specialty of EM, and secondarily to explore the factors reported as contributing to burnout.MethodsThis was a secondary analysis of the 2014 American Board of Emergency Medicine Longitudinal Survey of Emergency Physicians. We used multiple logistic regression to determine which factors were associated with reporting serious consideration of leaving EM, when stratified by years in practice and adjusting for individual, departmental, and institutional factors.ResultsThe response rate was 82%, (n = 868); 22.6% (194) were female and 77.4% (664) were males; and 83.9% (733) White. The mean age of men responding was significantly higher than women (52.7±11.9 vs. 44.9±10.4, p<0.001). Overall, there were no significant gender differences in reporting having had serious thoughts of leaving EM in either unmatched or age-matched analyses. More women reported that burnout was a significant problem, while men more often were equivocal as to whether it was a problem. When stratified by years in practice, mid-career women had a seven-fold increase in the odds ratio (OR) of seriously considered leaving EM, compared to men of similar years in practice (OR 7.07, 95% confidence interval, 2.45–20.39). Autonomy at work, control over working conditions, fair compensation, personal reward, and a sense of ownership were factors associated with a lower rate of reporting considering leaving EM.ConclusionOur findings suggest that the intention to leave EM is not more prevalent in women. However, mid-career women more often reported seriously considering leaving the specialty than mid-career men. Further research on the factors behind this finding in mid-career women in EM is needed.
Highlights
Burnout is prevalent among emergency physicians and may cause physicians to consider leaving the practice of emergency medicine (EM)
More women reported that burnout was a significant problem, while men more often were equivocal as to whether it was a problem
We found that an increasing desire to leave the field of EM was correlated with greater reporting that burnout heavily affected one’s day-to-day work for pay (Figure 2), and that the proportion of those reporting they had seriously considered leaving EM increased as self-reported burnout increased, with 76% of those in the highest burnout group reporting that they had considered leaving EM
Summary
Burnout is prevalent among emergency physicians and may cause physicians to consider leaving the practice of emergency medicine (EM). This study sought to determine whether there is a gender difference in reporting burnout and seriously considering leaving the specialty of EM, and secondarily to explore the factors reported as contributing to burnout. Burnout, defined as “a state of emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment,” is prevalent among physicians.[1] In the medical literature, burnout is often measured using the Maslach Burnout Inventory (MBI),[1] Oldenburg Inventory,[2] or single-item measures of emotional exhaustion and depersonalization.[3] prior work on emergency physicians (EP) demonstrated that self-reported burnout (as assessed by “have you thought you are experiencing burnout”) accurately predicted burnout as defined by MBI scores 72% of the time.[4] Burnout in physicians is associated with many negative effects including decreased job satisfaction,[5] an increase in intention to leave a job,[6,7] decreased job productivity,[8] increased medical errors and decreased patient safety,[9,10] and substance use disorders.[11] The prevalence of burnout in attending physicians across medical specialties is more than twice that observed in the general adult working population, with EPs reporting one of the highest burnout rates – between 48-70%.12,13,14. Data on gender differences in burnout in emergency medicine (EM) is lacking
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