Meaningful Pursuits May Cut Risk of Physician Burnout

Faculty physicians at academic medical centers may be less likely to experience burnout if they spend at least one day per week on the aspect of their work that is most meaningful to them, according to a report in the May 25 issue of Archives of Internal Medicine.

"Physicians are responsible for caring for the nation's sick, promoting the public health, advancing the science of medicine, and passing the torch of knowledge to the next generation of physicians," the authors wrote as background information in the article. "Unfortunately, despite the value and importance of these pursuits, an expanding body of literature reports growing personal distress among physicians and a decrease in their satisfaction with the practice of medicine. Specifically, numerous studies have documented high rates of burnout and poor mental health among U.S. physicians and have suggested that physician distress can have a profound impact on patient quality of care as well as on a physician’s personal health."

In addition to factors affecting all physicians, such as increased administrative work and less time with patients, academic faculty must navigate a variety of requirements that compete for their time. Each individual physician derives varying levels of satisfaction from these components, which include research, education and administrative responsibilities. To better understand how career fit--the extent to which an individual is able to focus on those aspects they find they most meaningful--influences burnout, Tait D. Shanafelt, M.D., and colleagues at Mayo Clinic, Rochester, Minn., conducted a survey of faculty physicians in the Department of Internal Medicine at a large academic medical center in the fall of 2007.

Of 556 physicians selected to participate, 465 (84 percent) returned surveys. When asked which aspect of work they found most meaningful, most (68 percent) reported patient care, whereas 19 percent selected research, 9 percent education, and 3 percent administration. Overall, 34 percent of faculty members met criteria for burnout, which include emotional exhaustion, depersonalization, and low personal accomplishment.

A total of 385 of 437 physicians (88 percent) spent at least 20 percent (about one day per week) of their effort on the activity they reported to be most personally meaningful; those who did had about half the rate of burnout as those who spent less than 20 percent of their time on this activity (29.9 percent vs. 53.8 percent). "The association between time spent in the most meaningful activity and burnout was strong and was the largest predictor of burnout on multivariate analysis after other factors were controlled for," the authors wrote.

"These findings have important implications for the administrative leadership and department chairs at academic medical centers. These centers are responsible for training the next generation of physicians, for serving as the primary origin of scientific discovery and advances in the fields of medicine and health care delivery, and for providing tertiary medical care to patients with complex and unusual health care problems. Their physician faculty is the most critical resource for academic medical centers to discharge these responsibilities to society," researchers concluded. "Efforts to optimize career fit may promote physician satisfaction and help to reduce attrition among academic faculty physicians."

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