Women, Younger Clinicians\u2019, and Caregivers\u2019 Experiences of Burnout and Well-being During COVID-19 in a US Healthcare System

Ellis C Dillon,Cheryl D Stults,Suzanne Pertsch,Sien Deng,Laurie Gregg,Melissa Hanley,Dominick L Frosch,P.T Koenig,Meghan Martinez,Nina Szwerinski,Jill Kacher Cobb,Sarina Le Sieur,Elizabeth Mahler

doi:10.1007/s11606-021-07134-4

Abstract

BackgroundThe COVID-19 pandemic brought rapid changes to the work and personal lives of clinicians.ObjectiveTo assess clinician burnout and well-being during the COVID-19 pandemic and guide healthcare system improvement efforts.DesignA survey asking about clinician burnout, well-being, and work experiences.ParticipantsSurveys distributed to 8141 clinicians from June to August 2020 in 9 medical groups and 17 hospitals at Sutter Health, a large healthcare system in Northern California.Main MeasuresBurnout was the primary outcome, and other indicators of well-being and work experience were also measured. Descriptive statistics and multivariate logistic regression analyses were performed. All statistical inferences were based on weighted estimates adjusting for response bias.Key ResultsA total of 3176 clinicians (39.0%) responded to the survey. Weighted results showed 29.2% reported burnout, and burnout was more common among women than among men (39.0% vs. 22.7%, p<0.01). In multivariate models, being a woman was associated with increased odds of reporting burnout (OR=2.19, 95% CI: 1.51–3.17) and being 55+ years old with lower odds (OR=0.54, 95% CI: 0.34–0.87). More women than men reported that childcare/caregiving was impacting work (32.9% vs. 19.0%, p<0.01). Even after controlling for age and gender, clinicians who reported childcare/caregiving responsibilities impacted their work had substantially higher odds of reporting burnout (OR=2.19, 95% CI: 1.54–3.11). Other factors associated with higher burnout included worrying about safety at work, being given additional work tasks, concern about losing one’s job, and working in emergency medicine or radiology. Protective factors included believing one’s concerns will be acted upon and feeling highly valued.ConclusionsThis large survey found the pandemic disproportionally impacted women, younger clinicians, and those whose caregiving responsibilities impacted their work. These results highlight the need for a holistic and targeted strategy for improving clinician well-being that addresses the needs of women, younger clinicians, and those with caregiving responsibilities.

Highlights

The COVID-19 pandemic has bought renewed focus and concern to the issue of healthcare clinician burnout
Burnout, defined by emotional exhaustion, depersonalization, and low personal accomplishment brought on by work,[4] is part of the larger construct of well-being, defined as “quality of life, which includes the absence of ill-being and the presence of positive physical, mental, social, and integrated well-being... across personal and work-life domains.”[5]. Factors impacting wellbeing include autonomy, financial stability, family dynamics and caregiving, organizational dynamics, and social support,[6,7,8] all areas that have been significantly affected by the pandemic
Clinician burnout is directly related to the structure and organization of health care, for example, work policies, environment, workload, personal autonomy, and leadership.[8,14,15,16]

Summary

Introduction

The COVID-19 pandemic has bought renewed focus and concern to the issue of healthcare clinician burnout. Across personal and work-life domains.”[5] Factors impacting wellbeing include autonomy, financial stability, family dynamics and caregiving, organizational dynamics, and social support,[6,7,8] all areas that have been significantly affected by the pandemic. This trend is especially concerning as previous research has shown burnout influences the quality of patient care, medical errors, patient experience, clinicians’ personal relationships, alcohol use, depression, suicidality, and early retirement.[9,10,11,12,13] clinician burnout is directly related to the structure and organization of health care, for example, work policies, environment, workload, personal autonomy, and leadership.[8,14,15,16]. Other factors associated with higher burnout included worrying about safety at work, being given additional work tasks, concern about

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