Burnout crisis among young and female emergency medicine physicians during the COVID-19 pandemic: applying the six areas of worklife model

Ting, Daniel K.; Poonja, Zafrina; Lee, Kenneth; Baylis, Jared

doi:10.1007/s43678-022-00298-w

Cited by 3 publications

(5 citation statements)

References 3 publications

(4 reference statements)

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“…[19][20]28 Our study also found that early-career physicians were at higher risk of EE, which during the pandemic may be explained by higher clinical workloads or scheduling complications with young children. 29 Although our data suggested that having children increased the odds of having EE and/or DP, these findings were not statistically significant. We posit that this signal may be because our respondents with children were fearful of bringing SARS-CoV-2 back to their families, which has been demonstrated in previous studies.…”

Section: Discussioncontrasting

confidence: 71%

“…Previous studies have identified older age and having children in the home as protective factors against burnout, but that early career status and female sex were risk factors 19–20,28 . Our study also found that early-career physicians were at higher risk of EE, which during the pandemic may be explained by higher clinical workloads or scheduling complications with young children 29 . Although our data suggested that having children increased the odds of having EE and/or DP, these findings were not statistically significant.…”

Section: Discussionsupporting

confidence: 56%

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“The Cost in the Individual”

et al. 2023

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Objectives: Emergency medicine (EM) confers a high risk of burnout that may be exacerbated by the COVID-19 pandemic. We aimed to determine the longitudinal prevalence of burnout in pediatric EM (PEM) physicians/fellows working in tertiary PEM departments across Canada and its fluctuation during the pandemic.Methods: A national mixed-methods survey using a validated 2-question proxy for burnout was distributed monthly through 9 months. The primary outcome was the trajectory in probability of burnout, which was examined as both emotional exhaustion (EE) and depersonalization (DP), EE alone, and DP alone. Secondary outcomes investigated burnout and its association with demographic variables. Quantitative data were analyzed using logistic regression for primary outcomes and subanalyses for secondary outcomes. Conventional content analysis was used to analyze qualitative data and generate themes.Results: From February to October 2021, 92 of 98 respondents completed at least 1 survey, 78% completed at least 3 consecutive surveys, and 48% completed at least 6 consecutive surveys. Predicted probability of EE was bimodal with peaks in May (25%) and October (22%) 2021. Rates of DP alone or having both EE and DP were approximately 1% and stable over the study period. Mid-career physicians were at lower risk of EE (odds ratio, 0.02; 95% confidence interval, 0-0.22) compared with early-career physicians. Underlying drivers of burnout were multifaceted. Conclusions:Our study suggests that increased COVID-19 case burden was correlated with EE levels during the third and fourth waves of the pandemic. Emotional exhaustion was worsened by systemic factors, and interventions must target common themes of unsustainable workloads and overwhelming lack of control.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionsupporting

confidence: 56%

“The Cost in the Individual”

et al. 2023

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“…There is no doubt that the backlogs of delayed surgeries and cancer cases will take a significant toll on our already strained healthcare system in the years to come (Hanna et al, 2020a ). In fact, the situation has been exacerbated by the loss of healthcare staff due to clinical burnout and high mental distress among primary care providers (Ting et al, 2022 ; Zador et al, 2022 ). In the short-term, embracing digital health developments such as telemedicine, remote monitoring, and virtual support programs for cancer patients have been proven effective in minimizing system level delays in cancer treatment as the pandemic evolves (Qian et al, 2020 ; Turco et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on hospital screening, diagnosis and treatment activities among prostate and colorectal cancer patients in Canada

Lee¹,

Ojo²,

Halat³

et al. 2023

Int J Health Econ Manag.

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Background Suspension of cancer screening and treatment programs were instituted to preserve medical resources and protect vulnerable populations. This research aims to investigate the implications of COVID-19 on cancer management and clinical outcomes for patients with prostate and colorectal cancer in Canada. Methods We examined hospital cancer screening, diagnosis, treatment, length of stay, and mortality data among prostate and colorectal cancer patients between April 2017 and March 2021. Baseline trends were established with data between April 2017 and March 2020 for comparison with data collected between April 2020 and March 2021. Scenario analyses were performed to assess the incremental capacity requirements needed to restore hospital cancer care capacities to the pre-pandemic levels. Results For prostate cancer, A 12% decrease in diagnoses and 5.3% decrease in treatment activities were observed during COVID-19 between April 2020 and March 2021. Similarly, a 43% reduction in colonoscopies, 11% decrease in diagnoses and 10% decrease in treatment activities were observed for colorectal cancers. An estimated 1,438 prostate and 2,494 colorectal cancer cases were undiagnosed, resulting in a total of 620 and 1,487 unperformed treatment activities for prostate and colorectal cancers, respectively, across nine provinces in Canada. To clear the backlogs of unperformed treatment procedures will require an estimated 3%-6% monthly capacity increase over the next 6 months. Interpretation. A concerted effort from all stakeholders is required to immediately ameliorate the backlogs of cancer detection and treatment activities. Mitigation measures should be implemented to minimize future interruptions to cancer care in Canada.

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“…Possible causes of the underrepresentation of women in EM in later career stages and roles include promotion discrepancies, salary deficits, burnout, traditional societal "norms" (e.g., time expectations regarding domestic and family activities), and gender-specific factors including sexual harassment, mistreatment, and gender bias in the workplace-all of which may lead to lack of pursuit and recruitment into leadership roles, but also differential attrition rates of female versus male EPs. 10,[13][14][15][16][17][18] Despite well-described risk factors for attrition of female EPs, studies to date have commonly relied on anticipatory surveys (asking respondents when they plan to leave the workforce) or have not looked specifically at the EP workforce. 19,20 Estimates across all specialties suggest that the majority of physicians exit clinical practice sometime between 60 and 69 years of age, 19 yet it stands to reason that EPs in general, and women in particular, given the above factors, may be prone to early attrition from clinical practice.…”

Section: Introductionmentioning

confidence: 99%

“…This decreasing percentage of female physicians at progressive milestones along the EM career continuum may be due to differences in attrition as earlier exit from the EM workforce by women may be one potential structural barrier to advancement. Possible causes of the underrepresentation of women in EM in later career stages and roles include promotion discrepancies, salary deficits, burnout, traditional societal “norms” (e.g., time expectations regarding domestic and family activities), and gender‐specific factors including sexual harassment, mistreatment, and gender bias in the workplace—all of which may lead to lack of pursuit and recruitment into leadership roles, but also differential attrition rates of female versus male EPs 10,13–18 …”

Section: Introductionmentioning

confidence: 99%

Emergency medicine physician workforce attrition differences by age and gender

Gettel

Courtney

Agrawal

et al. 2023

Academic Emergency Medicine

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BackgroundEmergency care workforce concerns have gained national prominence given recent data suggesting higher than previously estimated attrition. With little known regarding characteristics of physicians leaving the workforce, we sought to investigate the age and number of years since residency graduation at which male and female emergency physicians (EPs) exhibited workforce attrition.MethodsWe performed a repeated cross‐sectional analysis of EPs reimbursed by Medicare linked to date of birth and residency graduation date data from the American Board of Emergency Medicine for the years 2013–2020. Stratified by gender, our primary outcomes were the median age and number of years since residency graduation at the time of attrition, defined as the last year during the study time frame that an EP provided clinical services. We constructed a multivariate logistic regression model to examine the association between gender and EP workforce attrition.ResultsA total of 25,839 (70.2%) male and 10,954 (29.8%) female EPs were included. During the study years, 5905 male EPs exhibited attrition at a median (interquartile range [IQR]) age of 56.4 (44.5–65.4) years, and 2463 female EPs exhibited attrition at a median (IQR) age of 44.0 (38.0–53.9) years. Female gender (adjusted odds ratio 2.30, 95% confidence interval 1.82–2.91) was significantly associated with attrition from the workforce. Male and female EPs had respective median (IQR) post–residency graduation times in the workforce of 17.5 (9.5–25.5) years and 10.5 (5.5–18.5) years among those who exhibited attrition and one in 13 males and one in 10 females exited clinical practice within 5 years of residency graduation.ConclusionsFemale physicians exhibited attrition from the EM workforce at an age approximately 12 years younger than male physicians. These data identify widespread disparities regarding EM workforce attrition that are critical to address to ensure stability, longevity, and diversity in the EP workforce.

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Burnout crisis among young and female emergency medicine physicians during the COVID-19 pandemic: applying the six areas of worklife model

Cited by 3 publications

References 3 publications

“The Cost in the Individual”

“The Cost in the Individual”

Impact of COVID-19 on hospital screening, diagnosis and treatment activities among prostate and colorectal cancer patients in Canada

Emergency medicine physician workforce attrition differences by age and gender

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