Burnout risk factors

Call frequency and burden, number of years in practice, and sleep deprivation are associated with burnout of neurointerventional surgeons, sleeping at the wheel, motor vehicle crashes, and fatigue-related medical errors. These findings contribute to the increasing literature on physician burnout and may guide future societal recommendations related to call burden in neurointerventional surgery ¹⁾.

Excessive stress

Professional dissatisfaction.

Gender harassment

Higher burnout was seen in chaotic workplaces (odds ratio [OR], 1.51; 95% CI, 1.38-1.66; P < .001) and with low work control (OR, 2.10; 95% CI, 1.91-2.30; P < .001). Higher burnout was associated with poor teamwork (OR, 2.08; 95% CI, 1.78-2.43; P < .001), while feeling valued was associated with lower burnout (OR, 0.22; 95% CI, 0.18-0.27; P < .001). In time trends, burnout was consistently higher with chaos and poor work control ²⁾.

In the context of long hours and alternating shifts and sleep cycles, the lack of exercise and poor dietary choices may have negative short- and long-term consequences on physician physical and mental health. Historically, “resident” physicians lived in the hospital and were entirely devoted to caring for their patients; thus, personal health was abandoned in the pursuit of medical education. We now teach residents in the context of enforced duty-hour restrictions. However, it is commonplace for physicians (residents and faculty) to be “too busy” to frequent the doctor for routine visits such as health screenings that they themselves would outline for their own patients. Chronic diseases with courses that can be either modified or entirely prevented can thus go unnoticed for many years, causing irreparable damage; for example, undiagnosed hypertension or hypercholesterolemia leading to cardiovascular disease or stroke. In addition, there is increasing data suggesting that psychological distress and burnout are common among physicians and other healthcare providers. Approximately 45% to 70% of residents report burnout during training ³⁾ ⁴⁾ ⁵⁾ ⁶⁾ ⁷⁾ ⁸⁾ but these issues do not end with completion of residency. Nearly 50% of US physicians report symptoms of burnout ⁹⁾ With an expanding understanding of the health consequences of medicine on the provider, there has been an increasing focus on improving physician well-being ¹⁰⁾ ¹¹⁾ ¹²⁾.

Merit-Based Incentive Payment System [MIPS]) participation may increase after-hours documentation burden among US office-based physicians, suggesting that physicians may require additional resources to more efficiently report data ¹³⁾.

Santos CN, Pedrosa BF, Martins M, Gouveia F, Franco F, Vardasca MJ, Pedro B, Nogueira JD. Interruptions during general practice consultations: negative impact on physicians, and patients' indifference. Fam Pract. 2022 Nov 21:cmac129. doi: 10.1093/fampra/cmac129. Epub ahead of print. PMID: 36409278.

High prevalence of burnout among residents during the COVID-19 pandemic. Individual characteristics and conditions related to the work environment were associated with a higher or lower occurrence of the syndrome ¹⁴⁾.

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Abdalla RN, Ansari SA, Hurley MC, Attarian H, Fargen KM, Hirsch JA, Cantrell DR, Curl PK, Daves PR, Shaibani A. Correlation of Call Burden and Sleep Deprivation with Physician Burnout, Driving Crashes, and Medical Errors among US Neurointerventionalists. AJNR Am J Neuroradiol. 2022 Sep;43(9):1286-1291. doi: 10.3174/ajnr.A7606. Epub 2022 Aug 25. PMID: 36007952; PMCID: PMC9451637.

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Linzer M, Jin JO, Shah P, Stillman M, Brown R, Poplau S, Nankivil N, Cappelucci K, Sinsky CA. Trends in Clinician Burnout With Associated Mitigating and Aggravating Factors During the COVID-19 Pandemic. JAMA Health Forum. 2022 Nov 4;3(11):e224163. doi: 10.1001/jamahealthforum.2022.4163. PMID: 36416816.

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Gelfand DV, Podnos YD, Carmichael JC, Saltzman DJ, Wilson SE, Williams RA. Effect of the 80-hour workweek on resident burnout. Arch Surg. 2004;139(9):933- 938; discussion 938-940.

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Ripp JA, Bellini L, Fallar R, Bazari H, Katz JT, Korenstein D. The impact of duty hours restrictions on job burnout in internal medicine residents: a three-institution comparison study. Acad Med. 2015;90(4):494-499.

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Ripp J, Babyatsky M, Fallar R, et al. The incidence and predictors of job burnout in first-year internal medicine residents: a five-institution study. Acad Med. 2011; 86(10):1304-1310.

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Kimo Takayesu J, Ramoska EA, Clark TR, et al. Factors associated with burnout during emergency medicine residency. Acad Emerg Med. 2014;21(9):1031-1035.

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Yost MG, Johnson JC, Johns MM III, Burchett KD. Burnout among osteopathic otolaryngology residents: identification during formative training years. J Am Osteopath Assoc. 2014;114(8):632-641.

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Campbell J, Prochazka AV, Yamashita T, Gopal R. Predictors of persistent burnout in internal medicine residents: a prospective cohort study. Acad Med. 2010;85(10):1630-1634.

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Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377-1385

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Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann Fam Med. 2014;12(6):573-576.

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Daskivich TJ, Jardine DA, Tseng J, et al. Promotion of wellness and mental health awareness among physicians in training: perspective of a national, multispecialty panel of residents and fellows. J Grad Med Educ. 2015;7(1):143-147.

¹²⁾

Lefebvre DC. Perspective: resident physician wellness: a new hope. Acad Med. 2012;87(5):598-602.

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Nguyen OT, Turner K, Parekh A, Alishahi Tabriz A, Hanna K, Merlo LJ, Hong YR. Merit-based incentive payment system participation and after-hours documentation among US office-based physicians: Findings from the 2021 National Electronic Health Records Survey. J Eval Clin Pract. 2022 Nov 22. doi: 10.1111/jep.13796. Epub ahead of print. PMID: 36416004.

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Pinho RDNL, Costa TF, Silva NM, Barros-Areal AF, Salles AM, Oliveira APRA, Rassi CHRE, Gomes CM, Silva DLMD, Oliveira FAR, Jochims I, Vaz Filho IHR, Oliveira LAB, Rosal MA, Lima MP, Soares MVA, Kurizky PS, Peterle VCU, Gomides APM, Mota LMHD, Albuquerque CP, Simaan CK, Amado VM. High prevalence of burnout syndrome among medical and nonmedical residents during the COVID-19 pandemic. PLoS One. 2022 Nov 22;17(11):e0267530. doi: 10.1371/journal.pone.0267530. PMID: 36413548.