Physician Burnout and the Calling to Care for the Dying: A National Survey

Yoon, John D.; Hunt, Natalie B.; Ravella, Krishna C.; Jun, Christine S.; Curlin, Farr A.

doi:10.1177/1049909116661817

Cited by 30 publications

(24 citation statements)

References 38 publications

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“…(8) This rate, compared to other medical specialties, ranks among the highest. (1) Whereas a recent U.S. survey by Yoon and colleague found burnout rates among palliative care clinicians lower than ours (23%),(9) that study used a validated single-item measure of burnout, compared to our more exhaustive assessment that used the Maslach Burnout Inventory. (10) Nevertheless, although quantifying the prevalence of burnout within palliative care clinicians is important, there remains a need to understand the lived experience of burnout in this population as defined by clinicians themselves, as well as the sources of burnout, its protective factors, and downstream effects.…”

Section: Introductionmentioning

confidence: 61%

“It Is Like Heart Failure. It Is Chronic … and It Will Kill You”: A Qualitative Analysis of Burnout Among Hospice and Palliative Care Clinicians

Kavalieratos

Siconolfi

Steinhauser

et al. 2017

Journal of Pain and Symptom Management

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Context Although prior surveys have identified rates of self-reported burnout among palliative care clinicians as high as 62%, limited data exist to elucidate the causes, ameliorators, and effects of this phenomenon. Objectives We explored burnout among palliative care clinicians, specifically their experiences with burnout, their perceived sources of burnout, and potential individual, interpersonal, organizational, and policy-level solutions to address burnout. Methods During the 2014 AAHPM/HPNA Annual Assembly, we conducted 3 focus groups to examine: personal narratives of burnout; how burnout differs within hospice and palliative care; and, strategies to mitigate burnout. Two investigators independently analyzed data using template analysis, an inductive/deductive qualitative analytic technique. Results We interviewed 20 palliative care clinicians (14 physicians, 4 advanced practice providers, 2 social workers). Common sources of burnout included: increasing workload, tensions between non-specialists and palliative care specialists, and regulatory issues. We heard grave concerns about the stability of the palliative care workforce, and concerns of providing, high-quality palliative care in light of a distressed, overburdened discipline. Participants proposed anti-burnout solutions including: promoting the provision of generalist palliative care, frequent rotations on-and-off service, and organizational support for self-care. We observed variability in sources of burnout between clinician type and by practice setting, such as role monotony among full-time clinicians. Conclusion Our results reinforce and expand upon the severity and potential ramifications of burnout on the palliative care workforce. Future research is needed to confirm our findings and to investigate interventions to address or prevent burnout.

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Section: Introductionmentioning

confidence: 61%

“It Is Like Heart Failure. It Is Chronic … and It Will Kill You”: A Qualitative Analysis of Burnout Among Hospice and Palliative Care Clinicians

Kavalieratos

Siconolfi

Steinhauser

et al. 2017

Journal of Pain and Symptom Management

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“…In a 2017 survey of US physicians, 43.9% reported burnout and the prevalence of burnout symptoms across specialties ranged from 29.6% (preventative medicine/occupational medicine) to 54.9% (emergency medicine) [ 23 ]. With respect to palliative care physicians in the United States, burnout prevalence rates have been reported as ranging from 33 to 38% [ 24 , 25 ] in addition to a more recent clarification on an earlier reported study reflecting 38.7% [ 26 , 27 ]. Similar work on burnout in palliative care physicians in other countries have been reported as 41.9% in Singapore [ 28 ] and 24% in Australia [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

Burnout and resilience among Canadian palliative care physicians

et al. 2020

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Background Physicians experience high rates of burnout, which may negatively impact patient care. Palliative care is an emotionally demanding specialty with high burnout rates reported in previous studies from other countries. We aimed to estimate the prevalence of burnout and degree of resilience among Canadian palliative care physicians and examine their associations with demographic and workplace factors in a national survey. Methods Physician members of the Canadian Society of Palliative Care Physicians and Société Québécoise des Médecins de Soins Palliatifs were invited to participate in an electronic survey about their demographic and practice arrangements and complete the Maslach Burnout Inventory for Medical Professionals (MBI-HSS (MP)), and Connor-Davidson Resilience Scale (CD-RISC). The association of categorical demographic and practice variables was examined in relation to burnout status, as defined by MBI-HSS (MP) score. In addition to bivariable analyses, a multivariable logistic regression analysis, reporting odds ratios (OR), was conducted. Mean CD-RISC score differences were examined in multivariable linear regression analysis. Results One hundred sixty five members (29%) completed the survey. On the MBI-HSS (MP), 36.4% of respondents reported high emotional exhaustion (EE), 15.1% reported high depersonalization (DP), and 7.9% reported low personal accomplishment (PA). Overall, 38.2% of respondents reported a high degree of burnout, based on having high EE or high DP. Median CD-RISC resilience score was 74, which falls in the 25th percentile of normative population. Age over 60 (OR = 0.05; CI, 0.01–0.38), compared to age ≤ 40, was independently associated with lower burnout. Mean CD-RISC resilience scores were lower in association with the presence of high burnout than when burnout was low (67.5 ± 11.8 vs 77.4 ± 11.2, respectively, p < 0.0001). Increased mean CD-RISC score differences (higher resilience) of 7.77 (95% CI, 1.97–13.57), 5.54 (CI, 0.81–10.28), and 8.26 (CI, 1.96–14.57) occurred in association with age > 60 as compared to ≤40, a predominantly palliative care focussed practice, and > 60 h worked per week as compared to ≤40 h worked, respectively. Conclusions One in three Canadian palliative care physicians demonstrate a high degree of burnout. Burnout prevention may benefit from increasing resilience skills on an individual level while also implementing systematic workplace interventions across organizational levels.

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“…When recruiting new employees, companies prefer to hear applicants say that they want the job because it is their “calling.” Doing so conveys that employees see their job as meaningful, do not focus only on salary, are more committed, are more resistant to burnout, and have a tendency to experience high job satisfaction (Elangovan, Pinder, & McLean, 2010; Yoon, Daley, & Curlin, 2016; Yoon, Hunt, Ravella, Jun, & Curlin, 2016). Work as calling denotes a belief in being beckoned by some transcendent summons (e.g., God or the needs of society) to do a job for the well‐being of society (Dik & Duffy, 2009).…”

mentioning

confidence: 99%

Discerning Work as a Calling: The Role of Job Crafting

Riasnugrahani

Riantoputra

Takwin

et al. 2019

The Career Development Quart

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On the basis of career construction theory (CCT), the authors aimed to describe mechanisms by which work may be perceived as a calling. They did so by measuring the mediation and moderation effects of job crafting and power distance orientation (PDO) within the relationship between cognitive flexibility and calling. PDO levels become essential for high‐power‐distance societies such as Indonesia because PDO can decrease proactive behaviors, such as job crafting. Three hundred four employees in Indonesia responded to measures of calling, PDO, job crafting, and cognitive flexibility. Analyses indicated that the relationship between cognitive flexibility and calling is mediated by cognitive crafting and moderated by PDO. Results support CCT as useful for understanding the mechanisms of calling. For a high‐power‐distance country, the process of discerning a calling is influenced by submissive attitudes toward a superior. Thus, in assisting job‐crafting processes, counselors should focus on the relationship between employees and their superiors.

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Physician Burnout and the Calling to Care for the Dying: A National Survey

Abstract: Physicians from end-of-life specialties not only did not have increased rates of burnout but they were also more likely to report a sense of calling in caring for the dying.

Cited by 30 publications

References 38 publications

“It Is Like Heart Failure. It Is Chronic … and It Will Kill You”: A Qualitative Analysis of Burnout Among Hospice and Palliative Care Clinicians

“It Is Like Heart Failure. It Is Chronic … and It Will Kill You”: A Qualitative Analysis of Burnout Among Hospice and Palliative Care Clinicians

Burnout and resilience among Canadian palliative care physicians

Discerning Work as a Calling: The Role of Job Crafting

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