Longitudinal Study Evaluating the Association Between Physician Burnout and Changes in Professional Work Effort

Publié le 06 septembre 2016 • Catégorie(s) : Conditions de travail et santé psychologique • Mot(s) clef(s) : médecins, surmenage professionnel

Auteur        Tait D. Shanafelt
Auteur        Michelle Mungo
Auteur        Jaime Schmitgen
Auteur        Kristin A. Storz
Auteur        David Reeves
Auteur        Sharonne N. Hayes
Auteur        Jeff A. Sloan
Auteur        Stephen J. Swensen
Auteur        Steven J. Buskirk
Volume        91
Numéro        4
Pages        422-431
Publication        Mayo Clinic Proceedings
ISSN        1942-5546
Date        Apr 2016
Résumé        OBJECTIVE: To longitudinally evaluate the relationship between burnout and professional satisfaction with changes in physicians’ professional effort. PARTICIPANTS AND METHODS: Administrative/payroll records were used to longitudinally evaluate the professional work effort of faculty physicians working for Mayo Clinic from October 1, 2008, to October 1, 2014. Professional effort was measured in full-time equivalent (FTE) units. Physicians were longitudinally surveyed in October 2011 and October 2013 with standardized tools to assess burnout and satisfaction. RESULTS: Between 2008 and 2014, the proportion of physicians working less than full-time at our organization increased from 13.5% to 16.0% (P=.05). Of the 2663 physicians surveyed in 2011 and 2776 physicians surveyed in 2013, 1856 (69.7%) and 2132 (76.9%), respectively, returned surveys. Burnout and satisfaction scores in 2011 correlated with actual reductions in FTE over the following 24 months as independently measured by administrative/payroll records. After controlling for age, sex, site, and specialty, each 1-point increase in the 7-point emotional exhaustion scale was associated with a greater likelihood of reducing FTE (odds ratio [OR], 1.43; 95% CI, 1.23-1.67; P<.001) over the following 24 months, and each 1-point decrease in the 5-point satisfaction score was associated with greater likelihood of reducing FTE (OR, 1.34; 95% CI, 1.03-1.74; P=.03). On longitudinal analysis at the individual physician level, each 1-point increase in emotional exhaustion (OR, 1.28; 95% CI, 1.05-1.55; P=.01) or 1-point decrease in satisfaction (OR, 1.67; 95% CI, 1.19-2.35; P=.003) between 2011 and 2013 was associated with a greater likelihood of reducing FTE over the following 12 months. CONCLUSION: Among physicians in a large health care organization, burnout and declining satisfaction were strongly associated with actual reductions in professional work effort over the following 24 months.