Professional fulfillment and burnout among physicians at a large NCI-designated Comprehensive Cancer Center

Abstract

<h3>Objectives:</h3> We sought to assess composite physician wellness and burnout at a large NCI-designated Comprehensive Cancer Center and to determine the association of performance on the Stanford Professional Fulfillment Index (PFI) with career satisfaction. <h3>Methods:</h3> This was a cross-sectional study of physicians employed at the James Cancer Hospital at The Ohio State University in December of 2019 using a 115-question instrument that included the PFI, demographics and other validated measures of wellbeing and compassion. The PFI is a validated 16-item survey that measures burnout and professional fulfillment using a five-point Likert scale. Data were analyzed using independent t-tests, ANOVAs, and Pearson's correlations. <h3>Results:</h3> A total of 173 physicians responded (46.6% response rate) with 141 respondents completing at least 75% of the survey. Sixty-three percent were males (n=89), 70% between the ages of 30-49 (n=98), and 29% with between 5-10 years of clinical practice (n=41). Respondents worked a mean of 62 hours per week (range 8-120, Med=60) with over half of the cohort providing direct clinical care for >50% of this time (58%, n=82). Thirty-four percent of respondents were medical oncologists (n=48), 32% were surgeons (n=45), 20% were hospital-based (radiation oncology, anesthesiologists, and hospitalists (n=28), and 14% self-classified as other (n=20). 87% of respondents were married/partnered (n=123) with a majority of partners/spouses in a nonmedical field or out of the workforce (n=76, 54%). Most respondents had children at home (n=85, 60%). There were no relationships between PFI subscale scores and collected demographic data (Table 1). All PFI subscales were significantly correlated with all categories of personal/professional support. Support from administration demonstrated the strongest correlation with both Professional Fulfillment and Burnout. PFI Burnout was significantly correlated with average hours worked per week. Higher scores on PFI Professional Fulfillment were associated with a willingness to encourage their children to pursue medicine and a report that they would again pursue medicine as a career; higher PFI Burnout scores produced the opposite effect. Finally, all PFI scales were significantly correlated with a likelihood of leaving their current practice within two years. <h3>Conclusions:</h3> There were no differences between PFI performance and traditional demographic variables, however an increase in hours worked per week was associated with higher rates of reported exhaustion, disengagement and overall burnout. Participant attitudes toward medicine as a profession highlight the role of professional fulfillment and burnout in how personal and professional decisions are made. Additionally, we found that performance on the PFI was associated with a likelihood of leaving the institution. These findings could identify a cohort of physicians who would benefit from additional intervention and support.