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September 06, 2019
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Division directors show high concern over physician burnout

Many medical directors said they believe that physician burnout is a problem in their division and cite inherent work characteristics as a contributing factor to the issue, a recent qualitative survey suggests.

“Even under ideal working conditions, inherent work characteristics can contribute to burnout, which may relate to distinct challenges in caring for critically or chronically ill patients,” the researchers wrote. “Productivity pressure in the forms of relative value unit (RVU) standards limits the duration of clinical encounters and may come into direct conflict with patient quality, safety or other organizational goals of care.”

Researchers examined free-text responses from a May 2018 survey regarding solutions and drivers of burnout. Surveys were sent to members of the American Thoracic Society’s Association of Pulmonary, Critical Care, and Sleep Division Directors (APCCSD), with 74 of 214 directors issuing responses. Three questions were included in the survey to address whether respondents saw burnout as an issue in their division, what the biggest burnout drivers were and potential interventions to combat burnout. Each response was evaluated independently by three researchers and assigned codes corresponding to key concepts in the response.

For the analysis, researchers identified three response themes — individual, inherent and existent work characteristics. Existent work characteristics such as excessive workload, inadequate support and misalignment between clinicians and administrators were identified as drivers of burnout by most directors, with 79.7% indicating burnout in general as an issue in their division.

Solutions proposed by respondents were categorized as targeted if the response focused on a specific driver, as general if a specific driver was not identified or as absent if no solution was mentioned. None of the submitted solutions addressed inherent work characteristics specifically.

“While many of the identified targeted solutions are resource-intensive, there is a robust business case for addressing burnout,” the researchers wrote. “As local leaders search for ways to combat a growing burnout crisis, our results may provide some guidance on pragmatic solutions for promoting physician well-being and offer areas for further investigation.” – by Eamon Dreisbach

Disclosure: Rinne reports funding by a VA Health Services Research and Development Career Development Award and a Parker B. Francis Foundation Fellowship.