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Burnout in gastroenterologists more related to work-life balance than employment factors
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ORLANDO — A survey of more than 700 gastroenterologists revealed that nearly half experienced burnout, and that work-life balance drives it more often than practice-related issues.
“Higher rates of burnout were reported in younger gastroenterologists, those who are spending more time doing domestic chores, and those who are doing patient-related work at home,” outgoing ACG President Carol Burke, MD, of the Cleveland Clinic, said while presenting these results at the World Congress of Gastroenterology at ACG 2017. “These physicians are often times also neutral or dissatisfied with their partner or spousal relationship, and they’re also planning to leave the practice of gastroenterology early.”
Burke described burnout as “a syndrome characterized by emotional exhaustion, loss of enthusiasm for the work that you’re doing, depersonalization — which is cynicism or lack of compassion for patients and peers, treating them as objects — and a diminished sense of personal accomplishment.”
To determine the prevalence of and risk factors for burnout among gastroenterologists, Burke and colleagues emailed a 60-item survey to more than 11,000 ACG members between 2014 and 2015, which included the 22-item Maslach Burnout Inventory to measure burnout.
“The survey queried many aspects of both professional and personal life,” Burke said, including: demographics, employment setting, location, compensation type, hours at work, percentage of time in the clinic, hospital, doing endoscopy and research, time allotted for visit types, ease of use of EMR and typing skills, hours spent on domestic activities, performing patient-related work at home, and call, vacation and CME days taken.
“We also inquired about the spouse or partner, their employment status, hours at work and on domestic chores, and satisfaction with your spouse or partner relationship,” Burke said. “We also checked into some aspects of wellness, the percent of meals eaten, the amounts of exercise engaged in, BMI and volunteerism.”
Overall, 1,021 returned the survey (9.2% response rate), of which 754 were fully completed and included in the analysis. Among these respondents (mean age, 54 years), 49% reported experiencing burnout, 17% experienced low personal accomplishment, 45% experienced emotional exhaustion, and 21% experienced depersonalization.
Most respondents (93.5%) worked full time and 61% worked in a private practice. They reported spending an average of 8 hours per day on direct patient care, 3 hours per day on administrative tasks and 2 hours per day on work at home. Most reported using an EMR, but almost half (47%) said it was not user-friendly.
Women reported higher levels of burnout than men (64.4% vs. 45.7%; P < .001), and doctors who reported burnout were younger than those who reported no burnout (mean age, 50.4 vs. 54.2 years; P < .001).
Factors impacting burnout
“Interestingly, part-time or full-time employment, the type of practice you were in, the practice location and compensation time had no impact on levels of burnout,” Burke said.
Higher levels of burnout were also reported among individuals who felt their EMR was not user-friendly (P = .002), those who spent more hours per week doing domestic chores (P < .001) and caring for children (P = .015), those who spent more hours doing patient-related tasks at home (P = .019), and those who were single or had an unemployed spouse or partner (P = .011). Additionally, burned out individuals who were in relationships were more likely to have a partner or spouse who spends more time working (P = .003), “but there was no substantial difference in their time spent doing chores or caring for children,” Burke said.
Those who reported burnout were also more likely to have no children or younger children at home.
“There was no substantial difference in moderate activity levels between individuals that were burned out and not burned out, but very interestingly, if you look at individuals that are eating 50% or more of their work days, having both breakfast and lunch, had less ... reported levels of burnout,” Burke noted.
In terms of relationship satisfaction, doctors who reported they were either neutral, extremely or somewhat dissatisfied with their partner (P < .001) “were much more likely to be in the high burnout category,” she added.
Notably, the survey results showed a large percentage (64%) of respondents said they wanted to retire or leave their practice, this was “substantially associated with high levels of burnout [P < .001].”
Of the 46% of respondents who said they were considering early retirement, changes in reimbursement and regulatory impact were the most common reasons, and “MOC was the third leading single feature,” Burke said.
Multivariable analysis showed that lower levels of burnout were correlated with older age (OR for each additional year = 0.94; 95% CI, 0.92-0.96), finding EMR to be user-friendly (OR = 0.56; 95% CI, 0.29-1.09), fewer hours spent per week doing domestic chores (OR for each additional 3 hours = 1.09; 95% CI, 1.01-1.06), being somewhat or extremely satisfied with your spousal relationship (OR = 0.53; 95% CI, 0.35-0.83), and eating breakfast and lunch on more than half of workdays (OR = 0.75; 95% CI, 0.54-1.04). Further, planning to retire early or leave your practice within 2 years was significantly associate with burnout (OR = 3.5; 95% CI, 2.5-4.9).
Finally, Burke said the results showed that almost 60% of respondents said they would use resources that promote professional and personal well-being.
“Burnout has serious implications on the GI workforce, and strategies and resources need to be addressed to increase the success in both the physician’s personal and professional life,” she concluded.
Burke also discussed how personal and organizational strategies can be used to combat burnout during the Practice Management Course held before the scientific meeting. – by Adam Leitenberger
Reference:
Burke C, et al. Abstract 8. Presented at: World Congress of Gastroenterology at American College of Gastroenterology Annual Scientific Meeting; Oct. 13-18, 2017; Orlando, FL.
Disclosures: The researchers report no relevant financial disclosures.