Saturday, January 25, 2020

The Latest Breaking News about Physician Burnout

Physician burnout: Which medical specialties feel the most stress?

An online survey of doctors finds an overall physician burnout rate of 42%, which is down from 46% five years ago. Three new entries in the top six specialties with the highest rates of burnout compared with last year’s edition of the survey provide medical students and residents with new insight into their future careers.

The numbers of physicians who report burnout vary greatly between specialties.

In the Medscape survey, the highest percentage of physician burnout occurred among these medical specialties:

Urology: 54%.
Neurology: 50%.
Nephrology: 49%.
Diabetes and endocrinology: 46%.
Family medicine: 46%.
Radiology: 46%.

The lowest rates of burnout were reported by physicians in these medical specialties:

Public health and preventive medicine: 29%.
Ophthalmology: 30%.
Orthopedics: 34%.
Psychiatry: 35%.
Otolaryngology: 35%.
General surgery: 35%.

These findings correlate well with other studies by the AMA, Mayo Clinic and Stanford.

Reasons for burnout vary among specialties.

Interference with lifestyle and home life.
Long hours
Unrelenting stress
Disappointment with choice of specialty, or mode of practice setting.
Physical or Emotional disturbance.
Medico-legal issues

What has been left out is pre-morbid emotional disturbances, such as bi-polar spectrum disorder, depression, anxiety. The selection of a particular specialty is often secondary or directly attributable to personality type. Social anxiety disorder would lead a physician into a specialty such as a pathology, or anesthesiology.

What is burnout?

Burnout among physicians was measured using the emotional exhaustion and depersonalization scales of the Maslach Burnout Inventory (MBI), a validated questionnaire considered the criterion standard tool for measuring burnout.28, 29, 30, 31 Consistent with convention,10, 32, 33 we considered physicians with a high score on the depersonalization and/or emotional exhaustion subscale of the MBI as having at least one manifestation of professional burnout.28

Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment


Although the MBI is the criterion standard for the assessment of burnout,28 its length and expense limit feasibility for use in long surveys addressing multiple content areas or in large population samples. Thus, to allow comparison of burnout between physicians and population controls, we measured burnout in both groups using 2 single-item measures adapted from the full MBI. These 2 items correlated strongly with the emotional exhaustion and depersonalization domains of burnout measured by the full MBI in a sample of more than 10,000 individuals,34, 35 with an area under the receiver operating characteristic curve of 0.94 and 0.93 for emotional exhaustion and depersonalization, respectively, for these single items relative to the full MBI.

Ocam's Razor

The simplest solution is often the correct one.  In this case, 3 out of four times  one criterion yields a correct answer to the question, In this case, depersonalizationThe single question with the highest factor loading on the emotional exhaustion (EE) (“I feel burned out from my work”) and depersonalization (DP) (“I have become more callous toward people since I took this job”) 





















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