Professional Fulfillment Research Articles

Opioid agonist treatment and trust in the community pharmacy setting: a qualitative study of perceptions and experiences

Background Opioid agonist treatment (OAT) in New South Wales Australia involves prescribed consumption of methadone or buprenorphine formulations and is commonly accessed through community pharmacies. People with a history of drug use often feel mistrusted and this can deter them from starting or staying in treatment. This study sought pharmacist and consumer perspectives to understand how treatment engagement can be best supported. Objective To explore consumer and pharmacist experiences of OAT services, identifying the social and structural elements that enhance or impair treatment and professional satisfaction and analyzing how these are influenced by trust. Methods Semi-structured interviews were conducted in 2021–2022 with 10 pharmacists and 15 consumers. Transcripts were analyzed using a realist thematic approach. Results Burdensome fees, pharmacy service problems, and system opportunities were generated as themes of subjection, and socially inclusive care and person-centered approaches as themes of connection. OAT consumers felt more inclusion when pharmacy practices did not differentiate or demean them and when pharmacists communicated in a personable and caring manner, and pharmacists recognized these aspects as contributing to greater professional fulfillment and less service problems. Conclusion OAT delivery in community pharmacies provides opportunities for greater social inclusion, particularly when trust and fairness are demonstrated.

A Mixed-Methods Cohort Study Evaluating the Impact of a One-Day Well-Being Course for Anesthesia Providers Working in Low-Resource Settings.

Burnout, depression, and anxiety are increasingly recognized as common among health care providers. Risks for these conditions are exacerbated in low-resource settings by excessive workload, high disease burden, resource shortage, and stigma against mental health issues. Based on discussions and requests to learn more about burnout during the Vital Anaesthesia Simulation Training (VAST), our team developed VAST Wellbeing, a 1-day course for health care providers in low-resource settings to recognize and mitigate burnout and to promote personal and professional well-being. This mixed-methods study used quantitative pre- and postcourse surveys using validated mental health measures and qualitative semistructured interviews to explore participants' experience of VAST Wellbeing during and after the course. Quantitative outcomes included burnout and professional fulfillment as measured by the Professional Fulfillment Index and general well-being as measured by the Warwick-Edinburgh Mental Wellbeing Scale. Twenty-six participants from 9 countries completed the study. In the immediate postcourse survey, study participants rated the course overall as "very good" (60.7%) and "excellent" (28.6%). Quantitative analysis showed no statistical differences in levels of work exhaustion, interpersonal disengagement, burnout, professional fulfillment, or general mental well-being 2 months after the course. Five themes on the impact of VAST Wellbeing were identified during qualitative analysis: (1) raising awareness, breaking taboos; (2) not feeling alone; (3) permission and capacity for personal well-being; (4) workplace empowerment; and (5) VAST Wellbeing was relevant, authentic, and needed. Causes of burnout are complex and multidimensional. VAST Wellbeing did not change measures of burnout and fulfillment 2 months postcourse but did have a meaningful impact by raising awareness, reducing stigma, fostering connection, providing skills to prioritize personal well-being, and empowering people to seek workplace change.

Stress and Burnout among Medical Specialists in Romania: A Comparative Study of Clinical and Surgical Physicians.

This study, which focuses on 227 participants (196 females and 31 males) comprising 187 clinical specialists and 40 surgical physicians, examines the prevalence of burnout in medical specialists. We investigate the effects of the emotional exhaustion (EE), Depersonalization (D), and personal accomplishment (PA) dimensions on professional satisfaction and plans to change careers using the modified licensed Maslach Burnout Inventory-Human Services Survey (MBI-HSS (MP)). High emotional exhaustion is reported by 52.63% of men and 71.28% of women in the clinical medicine group (n = 188). In the surgical specialties (n = 39), scores are significantly higher, with 75% of men and 77.77% of women reporting EE. In our sample group, 71.36% express high levels of emotional exhaustion, with similar patterns across specialization and gender. Clinical medicine respondents report high degrees of depersonalization in 33.13% of females and 21.05% of males, while surgical specialty respondents report high levels in 33.33% of females and 50% of males. Across genders and specializations, 33.03% of all respondents show high levels of depersonalization. Clinical medicine participants report high levels of personal accomplishment (42.60% of females and 42.10% of males), whereas surgical specialties report 44.44% of females and 66.66% of male on the PA dimension. Of the total number of respondents, 44.05% report having a high level of personal accomplishment; differences exist depending on specialty and gender. In addition, questions regarding professional fulfilment and intention to change careers were presented to the participants. A total of 53.40% (16 male and 105 female) of the clinical medicine respondents said they intended to change careers, while 33 participants (9 male, 34 female) doubted if they would remain in the same specialization. Furthermore, 86 individuals (9 male and 77 female) in the surgical specialties said they would never choose to work in healthcare again. Regression analysis suggests that being male, higher in age, and working in surgical specialties with lower job satisfaction and a higher intention to change profession are associated with higher levels of EE. Age and work satisfaction are significant predictors of depersonalization, and higher career satisfaction is associated with increased levels of PA.

Sudarshan Kriya Yoga Breathing and a Meditation Program for Burnout Among Physicians

Physicians are exposed to high stress and strain that results in burnout, which affects them, their families, their patients, and the entire health care system; thus, there is an urgent need to develop methods to increase the resiliency of physicians. Sudarshan Kriya Yoga (SKY) is a comprehensive yoga breathing and meditation-based program that is a potential approach to mitigate physician burnout. To determine whether SKY can reduce psychological distress and improve wellness in physicians. This randomized clinical trial assessed the potential efficacy of SKY compared with a stress management education (SME) training as control. This study was conducted online from November 11, 2021, to March 14, 2022, and included physicians from Turkey, Germany, and Dubai. Both the SKY and the SME control groups received 1.5 hours of training for 3 consecutive days via a group video conference call. Participants were physicians willing to do some form of relaxation exercise everyday for 2 months. Exclusion criteria included presence of major illness and maintaining a regular mind-body program practice. Statistical analysis took place from March to November 2023. Participants were randomly assigned 1:1 into 2 groups-the SKY group or the SME (control) group-using a computer algorithm. After the 3-day instruction period, the participants in the SKY group practiced for approximately 30 minutes per day on their own and participated in a weekly 1-hour, group-based online follow-up practice. After the 3-day instruction period, participants in the SME group reviewed and applied the notes from stress management education training at their initiative and had a weekly 1-hour group-based online follow-up session. The primary outcomes were stress and depression (measured by the 42-item Depression, Anxiety, and Stress Scale [DASS-42]) and insomnia measured by the Regensburg Insomnia Scale (RIS) with primary end point at 8 weeks. Secondary outcomes included anxiety (DASS-42); optimism (Life Orientation Test-Revised [LOT-R]); professional fulfillment, work exhaustion, interpersonal disengagement, and overall burnout (Professional Fulfillment Index [PFI]); and self-reported professional errors (Self-Reported Professional Error Questionnaire). This study included 129 participants (SME, 63 participants [48.9%]; SKY, 66 participants [51.1%]; 115 females [89.2%]; 14 males [10.8%]; mean [SD] age, 46.2 [9.0] years). Compared with the SME control group, participants in the SKY group had significantly decreased stress on the DASS-42 at posttraining (difference, -6.8 points; 95% CI, -9.6 to -4.1 points; P = .006) and at postintervention (difference, -6.0 points; 95% CI, -8.8 to -3.3 points; P = .03), significantly decreased depression at posttraining (difference, -5.7 points; 95% CI, -8.6 to -2.8 points; P < .001) and postintervention (difference, -5.4 points; 95% CI, -8.3 to -2.5 points; P < .001), and significantly decreased anxiety at postintervention. In addition, there was a significant decrease in insomnia from baseline to postintervention in the SKY group (difference, -0.3 points; 95% CI, -2.3 to 1.7 points; P = .01). The SKY group also showed significantly increased professional fulfillment as well as significant decreases in work exhaustion, interpersonal disengagement, and burnout. There was no effect on self-reported medical errors. In this randomized clinical trial, physicians who regularly practiced SKY throughout a 2-month period experienced improvements in wellness and decreased burnout. These data suggest that SKY may be an effective, practical, and safe strategy to increase wellness and mitigate burnout in physicians. ClinicalTrials.gov Identifier: NCT05956470.

Evaluating Systemic Burnout in Medical Oncology Through a National Oncology Mentorship Program.

Mentorship has a positive influence on trainee skills and well-being. A 2022 Pilot Mentorship Program in New South Wales involving 40 participants revealed high burnout rates in Medical Oncology trainees. As part of an Australia-wide inaugural National Oncology Mentorship Program in 2023 (NOMP23), a national survey was undertaken to assess the prevalence of burnout, anxiety, depression, professional fulfilment, and drivers of distress in the Australian medical oncology workforce. NOMP23 is a 1-year prospective cohort study that recruited medical oncology trainees and consultants using e-mail correspondence between February and March 2023. Each participant completed a baseline survey which included the Maslach Burnout Index (MBI), Stanford Professional Fulfilment Index, and Patient Health Questionnaire-4 for anxiety and depression. One hundred and twelve participants (56 mentors, 56 mentees) were enrolled in NOMP23, of which 86 (77%) completed the baseline survey. MBI results at baseline demonstrated that 77% of consultants and 82% of trainees experienced burnout in the past 12 months. Professional fulfilment was noted to be <5% in our cohort. Screening rates of anxiety and depression in trainees were 32% and 16%, respectively, compared with 7% and 2% for consultants. When assessing reasons for workplace stress, two thirds stated that heavy patient load contributed to stress, while almost three quarters attributed a heavy administrative load. Lack of supervision was a key stressor for trainees (39%), as was lack of support from the training college (58%). Trainees and consultant medical oncologists demonstrate high rates of burnout and low professional fulfilment. The NOMP23 program has identified a number of key stress factors driving burnout and demonstrated concerning levels of anxiety and depression. Ongoing mentorship and other well-being initiatives are needed to address these issues.

Evaluating a Scribe Program in Reducing Provider Burnout

Burnout causes decreased job satisfaction, mental health issues, and leads to poor patient care. A large contributor is the electronic health record. Primary care providers from a medical group completed the Professional Fulfillment and Burnout Index survey showing high rates of burnout, and a scribe program was initiated. This quality improvement project evaluated the scribe program and its effects on burnout, documentation burden, and productivity for primary care physicians and nurse practitioners. Most participants had burnout. After using scribes, most had improved work-life balance. The scribe program was an important resource to prevent burnout related to the electronic health record.

The association between number of learners and pharmacist and technician levels of burnout.

Little is known about the relationship between learner load and pharmacist and pharmacy technician burnout. Therefore, the purpose of this study was to examine the association between burnout and the number of learners (residents, students, and new employees) assigned to pharmacists or pharmacy technicians. A validated survey to measure burnout and professional fulfillment was administered to employees of a university health system's pharmacy service in 2019. A threshold analysis determined the optimal cutoff for number of learners trained that maximized the ability to predict binary outcomes. Chi-square and Fisher's exact tests were used, and effect sizes between percentages were reported. Finally, the adjusted associations between number of learners and outcomes were assessed using logistic regression. A total of 448 pharmacy staff members were included in the analysis. Of those, 57% (n = 254) worked in ambulatory care, 27.4% (n = 122) worked in an inpatient setting, and 15.7% (n = 70) worked in infrastructure. Pharmacists working in an inpatient setting who reported training 4 or more learners per year indicated significantly higher rates of burnout than those training fewer learners on both a single-item burnout assessment (64.3% vs 31.0%; P = 0.01; effect size, 0.68) and a 10-item burnout assessment (54.8% vs 13.8%; P = 0.01; effect size, 0.91). Similar results were not observed in pharmacists working in ambulatory care and infrastructure positions or in pharmacy technicians. Added precepting and training responsibilities may be associated with higher levels of burnout among pharmacy team members, particularly inpatient pharmacists.

Vacation Days Taken, Work During Vacation, and Burnout Among US Physicians

Vacation has been shown to be an important restorative activity in the general population; less is known about physicians' vacation behaviors and their association with burnout and professional fulfillment. To examine the number of vacation days taken per year and the magnitude of physician work while on vacation and their association with physician burnout and professional fulfillment, by individual and organizational characteristics. This cross-sectional survey of US physicians was conducted between November 20, 2020, and March 23, 2021. Data analysis was performed from March to July 2023. Burnout was measured using the Maslach Burnout Index, and professional fulfillment was measured using the Stanford Professional Fulfillment Index. Number of vacation days taken in the last year, time spent working on patient care and other professional tasks per typical vacation day (ie, work on vacation), electronic health record (EHR) inbox coverage while on vacation, barriers to taking vacation, and standard demographics were collected. Among 3024 respondents, 1790 of 3004 (59.6%), took 15 or fewer days of vacation in the last year, with 597 of 3004 (19.9%) taking 5 or fewer days. The majority, 2104 respondents (70.4%), performed patient care-related tasks on vacation, with 988 of 2988 (33.1%) working 30 minutes or more on a typical vacation day. Less than one-half of physicians (1468 of 2991 physicians [49.1%]) reported having full EHR inbox coverage while on vacation. On multivariable analysis adjusting for personal and professional factors, concern about finding someone to cover clinical responsibilities (odds ratio [OR], 0.48 [95% CI, 0.35-0.65] for quite a bit; OR, 0.30 [95% CI, 0.21-0.43] for very much) and financial concerns (OR, 0.49 [95% CI, 0.36-0.66] for quite a bit; OR, 0.38 [95% CI, 0.27-0.54] for very much) were associated with decreased likelihood of taking more than 3 weeks of vacation per year. Taking more than 3 weeks of vacation per year (OR, 0.66 [95% CI, 0.45-0.98] for 16-20 days; OR, 0.59 [95% CI, 0.40-0.86] for >20 days vs none) and having full EHR inbox coverage while on vacation (OR, 0.74; 95% CI, 0.63-0.88) were associated with lower rates of burnout on multivariable analysis, whereas spending 30 minutes or longer per vacation day on patient-related work (OR, 1.58; 95% CI, 1.22-2.04 for 30-60 minutes; OR, 1.97; 95% CI, 1.41-2.77 for 60-90 minutes; OR, 1.92; 95% CI, 1.36-2.73 for >90 minutes) was associated with higher rates of burnout. In this cross-sectional study of 3024 physicians, the number of vacation days taken and performing patient-related work while on vacation were associated with physician burnout. System-level efforts to ensure physicians take adequate vacation and have coverage for clinical responsibilities, including EHR inbox, may reduce physician burnout.

Pediatric Resident Well-being: A Group Concept Mapping Study

ObjectivePediatric residency programs invest substantial resources in supporting resident well-being. However, no pediatric resident well-being conceptual model exists to guide interventions. This study aimed to understand how a diverse stakeholder sample conceptualized well-being. MethodsWe used group concept mapping methodology. We sent a brainstorming survey to pediatric residents and program leaders at 24 US residencies with the prompt, “The experience of well-being for resident physicians includes…” Participants at 4 residencies sorted well-being ideas conceptually and rated idea importance. We performed multidimensional scaling and hierarchical cluster analysis to develop cluster maps. Using participant feedback and a consensus-driven process, we determined best cluster representation. We used pattern matching to compare domain ratings between subgroups. ResultsIn brainstorming, 136 residents and 22 program leaders from 22 residency programs generated 97 unique ideas. Ideas were sorted and rated by 33 residents, 14 program leaders. Eight domains aligning with 4 resident roles were identified. Domains were: 1) positive, safe, and diverse culture; 2) unity and connection; 3) professional fulfillment and mindset; 4) personal health and life satisfaction; 5) professional development and recognition; 6) schedule protections and downtime; 7) work systems and benefits; 8) proactive and compassionate leadership. Domains aligned with the following roles: 1) individual, 2) colleague, 3) employee, 4) emerging pediatrician. Residents placed higher value on schedule protections and downtime than program leaders, P < .05. ConclusionsPediatric resident well-being may be conceptualized as inter-related domains corresponding with various resident roles. Participants aligned on many well-being priorities but differed regarding work schedules.

ОСОБЕННОСТИ ЗАНЯТОСТИ И ТРУДОВОГО ПОВЕДЕНИЯ РУССКОГОВОРЯЩИХ ЖЕНЩИН, ПРОЖИВАЮЩИХ В ЗАРУБЕЖНЫХ СТРАНАХ

The object of the study is the work and employment behavior of Russian-speaking women living in foreign countries. The subject of the study is a set of socio-economic relations that develop in connection with the work and employment behavior of this category of women. The information base for the study is scientific publications, materials from Russian-speaking communities, and indepth structured interviews conducted by the authors. The prerequisites for the term “relocant” and its main differences from the terms “emigrant”, “refugee”, and “expat” are analyzed. Women are classified according to their moving reasons and status in the new country. Two groups of women who left before and after February 2022 have been identified and characterized. The study reveals that the main social interactions during professional fulfillment take place in the Russian-speaking environment, and also that the unofficial employment of Russian-speaking women generally prevails over the official one. The most common areas of employment for Russian-speaking women are described. Features of employment behavior when Russian-speaking women move to other countries have been identified: the desire to start their own business, increase creativity in the workplace, etc. Sources of support for this category of women, including Russian-speaking women's communities, and a classification of such communities have been studied and developed. Based on the research results, the authors conclude that Russianspeaking women successfully join foreign businesses, compete with local entrepreneurs, and find completely new niches for their business projects, but often their employment remains unofficial. Recommendations are made that special support communities for Russian-speaking migrants in receiving countries on the part of local authorities and the public, as well as various Russian speaking communities, would be useful.

Beyond Winning: Lived Experiences of Thriving Young Professionals Raised in Solo-Parent Families

Understanding the factors and mechanisms contributing to the success of thriving young professionals raised in solo-parent families can provide valuable insights into how these individuals overcame challenges and achieved personal and professional fulfillment. The research aimed to propose an intervention program based on the lived experiences of adults raised in solo-parent families, specifically their experiences, their views of their challenges, how they thrived despite being raised in solo-parent families, and what intervention program companies can implement for young professionals raised in solo-parent families. The study employed a phenomenological approach to analyze the participants' lived experiences and used thematic analysis to examine classifications and identify recurring themes in the data. The experiences of the participants included financial struggles, lack of understanding regarding parental separation, parental abandonment, toxic family dynamics, adverse emotions, and a fearful-avoidant attachment style during adult life. The participants viewed their challenges with a positive perspective and motivation to thrive in life. Despite being raised in a solo-parent family, they thrived through faith, a positive mindset, and grit.

Формирование профессиональных компетенций в вузах пожарно-технического профиля с учётом гендерных особенностей

Purpose. The article is devoted to the analysis of training female cadets at State Fire Academy of EMERCOM of Russia for their further professional fulfillment within the structures of EMERCOM and creation of a methodology for assessing professional training on its basis. The authors’ goal is to improve the process of qualified personnel training for EMERCOM. The authors’ tasks include analysis of regulations governing the subject area, employment statistics, job descriptions, curricula in various areas of training implemented at State Fire Academy of EMERCOM of Russia, syllabus of disciplines and competencies being formed, development of methods for analyzing training effectiveness. Methods. Statistical analysis, synthesis, classification, description, comparison, expert survey were used. Findings. A methodology has been developed for assessing the compliance of the competencies acquired during the training process in various areas of training with the positions held. The directions for female specialists training system development have been determined with consideration of gender features. Research application field. The developed approach can be applied in assessing the compliance of the competencies of graduates’ professional activities formed during educational process, both in educational organizations under the auspices of EMERCOM of Russia and in other educational organizations. Conclusions. The main objective of an educational organization is training highly qualified personnel who meet their future occupation requirements. Self-realization of the graduates of educational institutions of EMERCOM of Russia is complicated by the specifics of professions in the emergency sector. This may result in a depressed psychophysical state, and sometimes giving up the profession, which reduces the efficiency of spending budget funds. It is important to define the criteria and methods for assessing specialist training effectiveness from the point of view of professionally significant qualities availability in a graduate. The developed approach will make it possible to introduce changes into the training system.

Mentoring in a hospital setting: where do we stand?

Mentoring has long been a cornerstone of medical training, facilitating knowledge transfer and supporting the professional progression of learners. Today, it could play a crucial role in the professional fulfillment of young doctors navigating an increasingly complex and demanding hospital environment. However, current mentoring programs appear under-powered and hampered by significant organizational challenges. This article describes existing mentoring formats, assesses their strengths and weaknesses and suggests strategies to enhance traditional models and better address the contemporary needs of young physicians.

“We're seen as part of the supply chain of medicines rather than as the professionals that we are”: The wellbeing of community pharmacists during the COVID response

IntroductionChallenges facing community pharmacists in delivering and adapting services during the COVID-19 response have been reported. However, few qualitative studies have examined the impact of these experiences on their wellbeing, and what supports the profession requires in the future. Aim(s)To examine the work-related experiences and psychosocial needs of community pharmacists situated in the Republic of Ireland arising from the COVID-19 response. Method11 pharmacists and 1 representative were interviewed and data analysed through inductive thematic analysis. ResultsWork experiences were characterised by increased workload linked to multiple roles pharmacists played during the pandemic. Remaining open, meeting the social and medical needs of patients unable to easily access other primary services exerted its toll on pharmacists while at the same time providing a sense of professional fulfilment. Participants felt contributions made to the community during COVID-19 went largely unrecognised by the wider healthcare structure. This added to a prior sense of professional disenchantment arising from long-standing under-resourcing, lack of clinical autonomy and high administrative burden eroding their sense of purpose and meaning. Informal, peer-support networks were preferred over formal psychological support initiatives. ConclusionsThe post-pandemic environment is an opportune time for policy makers to reconsider the role of community pharmacists. Greater clinical autonomy beyond dispensing of medicines, for example, for example, would also serve to enhance the sense of purpose and meaning of pharmacists as healthcare professionals. The longer-term well-being of community pharmacists is contingent on recognition of the value that community pharmacy bring both to the healthcare system and wider society as a whole.

Leadership Impact on Lecturer Retention at University Preparation Programs in Malaysia

Many higher education institutions (HEIs) offer pre-university/foundation programs that help students transition from secondary school to universities, in Malaysia, or around the world. To be globally competitive and meet the needs of students looking to enter world class universities, HEIs in Malaysia often need to employ expatriate lecturers (ELs) (Trembath, 2016). Many ELs choose to depart their institution at the end of their first contract. This can have a negative impact on programs and adds additional recruitment costs to program budgets (Theron et al., 2014). This study’s purpose was to understand the importance of leadership and organizational climate on ELs’ decision to either renew their contract or depart. The objective was to provide the leaders of such programs with insights to help them mitigate the challenges expatriates face and develop a supportive environment that encourages longer-term commitment of lecturers beyond an initial contract.&#x0D; A convergent, parallel mixed methods research design was used for this study in which 63 participants completed an online questionnaire. In addition, 31 participants also completed a semi-structured interview. The research population for this study included current and former ELs who have worked at university preparation programs at Malaysian HEIs.&#x0D; Five themes that affect EL retention surfaced from the analysis of the qualitative and quantitative data: (a) professional growth and fulfilment, (b) the direct influence of the leader, (c) institutional factors, (d) cultural adjustment factors (Froese, 2012), and (e) country-specific factors. These key factors have influenced the decision making around contract renewal for ELs at Malaysian HEIs.&#x0D; Based on the results of this study, The Leadership Model for Expatriate Lecturer Satisfaction and Fulfillment was developed in order to guide program directors in developing a system to foster the conditions that encourage EL retention.

Protective and risk factors associated with substance use coping among healthcare workers during the COVID-19 pandemic.

Healthcare workers (HCWs) experienced high levels of stress and mental health consequences associated with the COVID-19 pandemic, which may have contributed to unhealthy coping behaviors, such as substance use coping (SUC). This study aimed to understand the extent of and predictors of SUC. The sample consisted of 263 HCWs in North Central Florida. Univariable and multivariable logistic regression analyses investigated whether moral injury and other work risk factors, protective factors, and clinically relevant symptoms (i.e., work exhaustion, interpersonal disengagement, depression, anxiety, and/or PTSD) were associated with likelihood of SUC. Clinically relevant levels of interpersonal disengagement and anxiety increased the likelihood of SUC. Mediational analyses found that interpersonal disengagement and anxiety explained 54.3% of the relationship between Self Moral Injury and SUC and explained 80.4% of the relationship between professional fulfillment and SUC. Healthcare supervisors should be aware that providers who are experiencing moral injury and less professional fulfillment may be experiencing significant interpersonal disengagement and anxiety, which could lead to SUC. Future studies should examine the effects of implementing targeted prevention and treatment interventions, along with longitudinal outcomes related to SUC behaviors.

Well-Being Parameters and Intention to Leave Current Institution Among Academic Physicians

Physician turnover interrupts care delivery and creates health care system financial burden. To describe the prevalence of burnout, professional fulfillment, and intention to leave (ITL) among physicians at academic-affiliated health care systems and identify institutional and individual factors associated with ITL. This cross-sectional study administered a survey to 37 511 attending-level medical specialists at 15 academic medical institutions participating in the Healthcare Professional Well-Being Academic Consortium. Data were collected from October 2019 to July 2021. Statistical analysis was performed from May 2022 to March 2023. Hypothesized institutional and individual determinants of occupational well-being. The main outcome was ITL, defined as having at least a moderate intention (a score of 2 on a 0-4 scale) to leave one's institution within the next 2 years. Additional outcomes included burnout and professional fulfillment, defined using published Professional Fulfillment Index cut points. Of 18 719 academic physician survey respondents (8381 [44.8%] male; 2388 [12.8%] Asian, 10 599 [56.6%] White, 1039 [5.6%] other race, 4693 [25.1%] unknown race; 294 [1.6%] Hispanic or Latina/Latino/Latinx), 6903 of 18 217 (37.9%) met criteria for burnout and 7301 of 18 571 (39.3%) for professional fulfillment; 5177 of 15 890 (32.6%) reported moderate or greater ITL. Burnout, professional fulfillment, and ITL varied across specialties. After adjusting for demographics, each 1-point increase (range 0-10) in burnout was directly associated with ITL (odds ratio [OR], 1.52 [95% CI, 1.49-1.55])c, and each 1-point increase in professional fulfillment was inversely associated with ITL (OR, 0.64 [95% CI, 0.63-0.65]). After adjusting for demographics, burnout, and professional fulfillment, each 1-point increase (range 0-10) in supportive leadership behaviors (OR, 0.83 [95% CI, 0.82-0.84]), peer support (OR, 0.93 [95% CI, 0.91-0.95]), personal-organizational values alignment (OR, 0.81 [95% CI, 0.80-0.82]), perceived gratitude (OR, 0.95 [95% CI, 0.92-0.97]), COVID-19 organizational support (OR, 0.88 [95% CI, 0.85-0.91]), and electronic health record helpfulness (OR, 0.95 [95% CI, 0.93-0.97]) were inversely associated with ITL, whereas each 1-point increase (range 0-10) in depression (OR, 1.08 [95% CI, 1.05-1.10]) and negative impact of work on personal relationships (OR, 1.09 [1.07-1.11]) were directly associated with ITL. In this cross-sectional study of academic physicians, 32.6% indicated moderate or higher ITL within 2 years. Burnout, lack of professional fulfillment, and other well-being factors were associated with ITL, suggesting the need for a comprehensive approach to reduce physician turnover.

Burned Out on Burnout—The Urgency of Equity-Minded Structural Approaches to Support Nurses

This JAMA Forum discusses a health equity framework to address burnout and professional fulfillment among nurses.

A Narrative Review on Radiation Oncology Physician Well-Being in the United States

Abstract Objective: To summarize articles reporting on burnout and well-being among attending and resident radiation oncologists in the United States in a narrative review. Methods: PubMed was searched for peer-reviewed articles from 2010 through 2023 reporting on burnout and well-being among radiation oncologists in the United States. Each study was critically reviewed and included if it reported primary data utilizing a validated tool to measure burnout among radiation oncologists. A subset of high-quality studies was included. Results: There are limited studies regarding burnout among radiation oncologists in the United States, especially when compared with data from other countries. Despite these limitations, there is a prevalence of burnout among radiation oncologists of all career stages, with rates of burnout ranging from 30% to 63%. A few smaller studies have explored interventions to decrease burnout and enhance professional fulfillment among radiation oncologists. Best practices to enhance professional fulfillment for radiation oncologists include optimizing support structures to alleviate physicians of administrative duties; including physicians in departmental decisions that affect their work; providing dedicated time for research; promoting work-life balance and job satisfaction; providing support for trainees, including psychological tool-focused approaches and humanities exercises; and encouraging mindfulness. Conclusions: A large cross-sectional study is warranted to further explore modern burnout rates and causes among radiation oncologists in the United States. This may inform areas of advocacy to improve professional fulfillment among radiation oncologists.

HUMAN FREEDOM – THE PATH TO PERFECTION OR THE PATH TO DESPAIR

The present study aims to analyze how contemporary man uses the divine gift of freedom. On the one hand, man, freed from sin through the Sacrament of Baptism, can grow in freedom to the extent that he opens himself to the work of grace and fulfills the deeds of freedom, that is, the virtues. On the other hand, caught up in the whirlwind of different life choices to find professional fulfillment, he may not find his desires fulfilled and not feel the joy of earthly life, thus falling prey to fears, fears, unhappiness, and neurotic-depressive behavior, amplified in recent years by the various global crises (the COVID-19 pandemic, the war in the Soviet space etc.).