Length, quality of vacation time may be linked to physician burnout
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Key takeaways:
- The number of vacation days taken and working while on vacation were associated with physician burnout.
- System-level efforts may reduce physician burnout.
The number of vacation days taken and time spent performing patient-related work while on vacation were associated with physician burnout, according to study results published in JAMA Network Open.
System-level efforts, such as providing support for taking vacation and ensuring physicians have coverage for clinical responsibilities, may reduce physician burnout, according to the researchers.
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“Our latest study of a nationally representative sample of U.S. physicians found that 63% of physicians experienced some symptoms of burnout,” Christine A. Sinsky, MD, MACP, vice president of professional satisfaction at the AMA, told Healio. “This matters to patients because errors are higher when physicians are burned out. It also matters to payers because of higher health care costs associated with burnout and to organizational leaders because of higher rates of physician turnover with burnout.”
Sinsky and colleagues conducted a cross-sectional study of 3,024 U.S. physicians to examine how the number of vacation days taken per year and the amount of time spent performing patient-related work on vacation each were associated with physician burnout and professional fulfillment. Researchers also assessed electronic health record inbox coverage while on vacation and barriers to taking vacation, including finding someone to cover clinical responsibilities, the financial impact of taking vacation and the volume of EHR inbox work to be faced on return.
Researchers used the Maslach Burnout Inventory to measure burnout and the Stanford Professional Fulfillment Index to measure professional fulfillment.
Of 3,004 respondents, 1,790 (59.6%) took 15 or fewer days of vacation, 1,193 (39.7%) took 6 to 15 days of vacation and 597 (19.9%) took 5 or fewer days of vacation in the previous 12 months.
Among 2,988 respondents, 2,104 (70.4%) reported performing patient-related work on a typical vacation day, with 1,116 of 2,104 (37.3%) working 1 to 30 minutes.
Of 2,991 respondents, 1,468 (49.1%) reported having full EHR inbox coverage while on vacation.
Concern about finding someone to cover clinical responsibilities (quite a bit of concern, OR = 0.48; 95% CI, 0.35-0.65; very much concerned, OR = 0.3; 95% CI, 0.21-0.43) and financial concerns (quite a bit, OR = 0.49; 95% CI, 0.36-0.66; very much, OR = 0.38; 95% CI, 0.27- 0.54) were associated with decreased likelihood of taking more than 3 weeks of vacation per year.
However, taking more than 3 weeks compared with no vacation per year (16-20 days, OR = 0.66; 95% CI, 0.45-0.98; > 20 days, OR = 0.59; 95% CI, 0.4-0.86) 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.
Full EHR inbox coverage while on vacation also was associated with higher likelihood of professional fulfillment (OR = 1.32; 95% CI, 1.13-1.56).
Spending 30 minutes or longer performing patient-related work on vacation (30-60 minutes, OR = 1.58; 95% CI, 1.22-2.04; 60-90 minutes, OR = 1.97; 95% CI, 1.41-2.77; > 90 minutes, OR = 1.92; 95% CI, 1.36-2.73) was associated with higher rates of burnout.
“These are actionable results,” Sinsky told Healio.
“Health system leaders who want to reduce burnout, and thereby also reduce turnover and improve quality, can make tangible changes to support physicians taking full vacation,” Sinsky added.
Specifically, system-level efforts, including full EHR inbox coverage, may reduce physician burnout, according to the researchers. They also recommended normalizing the expectation that physicians take adequate vacation and fully disconnect from clinical work while on vacation.