Patients, careers suffer when burnout builds up for physicians

International study examines intertwined effects as problem approaches global crisis.

Burnout is bad for career engagement of physicians and for patient safety, according to a new study that examined the effects together.

Workplace burnout among physicians is approaching crisis levels worldwide – possibly the highest levels seen in the history of health care systems, said the study, “Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis,” published this month in The BMJ.

The researchers said it was the first review to link physician burnout, career engagement, and quality of patient care “because these aspects are complementary of the overall efficiency of healthcare organisations according to existing theoretical frameworks and research evidence.”

The results are grim, and the authors called for new interventions including the improvement of health care organizational culture.

“The pervasive nature of physician burnout indicates a defective work system caused by deep societal problems and structural problems across the sector,” Matthias Weigl, Professor of Patient Safety at Bonn University, said in a news release about the latest findings. Weigl also penned an accompanying editorial about the results. “Urgent action is imperative for the safety of physicians, patients, and health systems, including interventions that are evidence based and system oriented, to design working environments that promote staff engagement and prevent burnout.

The results

Researchers examined 170 observational studies of 239,246 physicians largely from the United States and Europe, but with studies from other parts of the world. There were variations in definitions and survey questions, along with complex and interchangeable factors that affect patient safety incidents, so the authors advised caution in interpreting the data.

Among the findings, the study said physicians with burnout:

  • Are up to four times more likely to be dissatisfied with their jobs
  • More than three times as likely to have thoughts or intentions to leave their jobs or regret their career choices
  • Twice as likely to be involved in patient safety incidents and show low professionalism
  • More than twice as likely to receive low satisfaction ratings from patients

Lower job satisfaction was more prevalent in physicians aged 31 to 50 years working in emergency medicine and intensive care, while patient safety incident were more likely to occur in physicians aged 20 to 30 years working in those specialties. Burnout was lowest among general practitioners, the study said.

“Healthcare organisations should invest more time and effort in implementing evidence-based strategies to mitigate physician burnout across specialties, and particularly in emergency medicine and for physicians in training or residency,” the authors said. The study recognized the financial and medical effects as health care systems “across the globe are encountering a workforce crisis.”

“Our findings affirm that physician burnout can be a catalyst for the career disengagement of physicians and that burnout is associated with unsafe patient care, which costs billions to healthcare systems annually,” the study said. “Physician burnout deepens the workforce crisis and undermines a fundamental need societal need to be in receipt of safe care.”

The study was yet another this month to log effects of physician burnout, a problem that grew worse during the COVID-19 pandemic. The Mayo Clinic, Medical Economics and The Physicians Foundation all published data on the issue.