Impact of Burnout on Self-Reported Patient Care Among Emergency Physicians

Abstract

IntroductionBurnout is a syndrome of depersonalization, emotional exhaustion and sense of low personal accomplishment. Emergency physicians (EPs) experience the highest levels of burnout among all physicians. Burnout is associated with greater rates of self-reported suboptimal care among surgeons and internists. The association between burnout and suboptimal care among EPs is unknown. The objective of the study was to evaluate burnout rates among attending and resident EPs and examine their relationship with self-reported patient care practices.MethodsIn this cross-sectional study burnout was measured at two university-based emergency medicine residency programs with the Maslach Burnout Inventory. We also measured depression, quality of life (QOL) and career satisfaction using validated questionnaires. Six items assessed suboptimal care and the frequency with which they were performed.ResultsWe included 77 out of 155 (49.7%) responses. The EP burnout rate was 57.1%, with no difference between attending and resident physicians. Residents were more likely to screen positive for depression (47.8% vs 18.5%, p=0.012) and report lower QOL scores (6.7 vs 7.4 out of 10, p=0.036) than attendings. Attendings and residents reported similar rates of career satisfaction (85.2% vs 87.0%, p=0.744). Burnout was associated with a positive screen for depression (38.6% vs 12.1%, p=0.011) and lower career satisfaction (77.3% vs 97.0%, p=0.02). EPs with high burnout were significantly more likely to report performing all six acts of suboptimal care.ConclusionA majority of EPs demonstrated high burnout. EP burnout was significantly associated with higher frequencies of self-reported suboptimal care. Future efforts to determine if provider burnout is associated with negative changes in actual patient care are necessary.

Emergency Medicine Faculty Are Poor at Predicting Burnout in Individual Trainees: An Exploratory Study

“…7 It is troubling, however, that EM trainees report similarly high levels of burnout as practicing EM attendings. [2][3][4] Coupled with recent evidence demonstrating an association between physician burnout and lower quality of care, 3,8,12 accurate identification and effective methods of addressing physician burnout are paramount.…”

“…1 Burnout is prevalent among physicians (45%-55%), with emergency medicine (EM) physicians reporting the highest levels (65%-75%) among all specialties. [2][3][4] Burnout is associated with decreased physician effectiveness at work and poor health. 5,6 Burnout is also associated with lower career satisfaction and greater intention of physicians to leave their work, including early retirement.…”

“…7 Recent work demonstrated that burnout is prevalent (55%-65%) among EM trainees as early as the second year of training. 3,4,8 Efforts to ameliorate the impact of burnout on trainees have been suggested, although their effectiveness remains unclear. 9 One reason for the uncertain success of these wellness interventions may be due to their implementation among trainees en masse, without discrimination between those with high versus low levels of burnout.…”

Perceived Stress, Stressors, and Coping Mechanisms Among PGY1 Pharmacy Residents

“…Most of the available literature discusses stress experienced by resident physicians. Available data shows that medical residency training is associated with increased level of stress, 1 burnout syndrome and depression, 2,3 and decreased quality of life. 4 Some reports found that stress negatively affects patient care, 5 is associated with medical errors, 6 and increases risk of motor-vehicle accidents.…”

Stress and Burnout During the First Year of Residence Training in a University Teaching Hospital: Preliminary Date

“…They are also more likely to screen positive for depression [9]. Moreover, burnout has been linked to selfreported suboptimal patient care, deferred clinical decision making, and increased perceived medical errors [4,10,11]. Most studies in this field have focused on identifying type of stressors among residents and burnout prevalence in a specific medical specialty sample [12][13][14][15].…”