The Association Between a Sense of Calling and Physician Well-Being: A National Study of Primary Care Physicians and Psychiatrists.

Abstract

This study assesses the association between calling and physician well-being, clinical commitment, and burnout. In 2009-2010, a survey was mailed to 1504 primary care physicians (PCPs) and 512 psychiatrists drawn from the American Medical Association Physician Masterfile. The primary independent variable was a single-item measure that assessed physicians' level of calling. Main outcomes were markers of physician well-being (career satisfaction and morale), clinical commitment (intentions to reduce time spent in direct patient care, leave practice in a few years), and experiences of burnout. Adjusted response rates were 63% (896/1427) for PCPs and 64% (312/487) for psychiatrists. Forty-two percent of US PCPs and psychiatrists agree strongly that their practice of medicine is a calling. Physicians with a high sense of calling were less likely than those with low to report regret in choosing medicine as a career (18 vs. 38%; odds ratio 0.3; 95% confidence interval, 0.2-0.5), wanting to go into a different clinical specialty (28 vs. 49%; OR 0.4; 95% CI, 0.2-0.6), or wanting to leave the practice of medicine in the next few years (14 vs. 25%, OR 0.4; 95% CI 0.2-0.7). Physicians with a high sense of calling were less likely to report burnout (17 vs. 31% low calling, OR 0.4; 95% CI 0.3 to 0.7). Physicians who reported that medicine was a calling may be experiencing higher levels of career satisfaction, more durable clinical commitments, and resilience from burnout. Though physicians may differ on their understanding of the concept of calling in medicine, this study highlights an important factor that should be investigated further when assessing long-term workforce retention in the fields of primary care and psychiatry.