[Show abstract][Hide abstract] ABSTRACT: This article presents some observations from a workshop setting about the role of compulsiveness in the normal physician. Case examples illustrate the effect of this character trait on the professional, personal, and family life of the typical physician. Doubt, guilt feelings, and an exaggerated sense of responsibility form a compulsive triad in the personality of the physician. This triad manifests itself in both adaptive and maladaptive ways. This article focuses primarily on the maladaptive, including difficulty in relaxing, reluctance to take vacations from work, problems in allocating time to family, an inappropriate and excessive sense of responsibility for things beyond one's control, chronic feelings of "not doing enough," difficulty setting limits, hypertrophied guilt feelings that interfere with the healthy pursuit of pleasure, and the confusion of selfishness with healthy self-interest.
JAMA The Journal of the American Medical Association 11/1985; 254(20):2926-9. DOI:10.1001/jama.254.20.2926 · 35.29 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
Despite extensive data about physician burnout, to our knowledge, no national study has evaluated rates of burnout among US physicians, explored differences by specialty, or compared physicians with US workers in other fields.
We conducted a national study of burnout in a large sample of US physicians from all specialty disciplines using the American Medical Association Physician Masterfile and surveyed a probability-based sample of the general US population for comparison. Burnout was measured using validated instruments. Satisfaction with work-life balance was explored.
Of 27 276 physicians who received an invitation to participate, 7288 (26.7%) completed surveys. When assessed using the Maslach Burnout Inventory, 45.8% of physicians reported at least 1 symptom of burnout. Substantial differences in burnout were observed by specialty, with the highest rates among physicians at the front line of care access (family medicine, general internal medicine, and emergency medicine). Compared with a probability-based sample of 3442 working US adults, physicians were more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with work-life balance (40.2% vs 23.2%) (P < .001 for both). Highest level of education completed also related to burnout in a pooled multivariate analysis adjusted for age, sex, relationship status, and hours worked per week. Compared with high school graduates, individuals with an MD or DO degree were at increased risk for burnout (odds ratio [OR], 1.36; P < .001), whereas individuals with a bachelor's degree (OR, 0.80; P = .048), master's degree (OR, 0.71; P = .01), or professional or doctoral degree other than an MD or DO degree (OR, 0.64; P = .04) were at lower risk for burnout.
Burnout is more common among physicians than among other US workers. Physicians in specialties at the front line of care access seem to be at greatest risk.
Archives of internal medicine 08/2012; 172(18):1-9. DOI:10.1001/archinternmed.2012.3199 · 17.33 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To explore the work lives, professional satisfaction, and burnout of US physicians by career stage and differences across sexes, specialties, and practice setting.
We conducted a cross-sectional study that involved a large sample of US physicians from all specialty disciplines in June 2011. The survey included the Maslach Burnout Inventory and items that explored professional life and career satisfaction. Physicians who had been in practice 10 years or less, 11 to 20 years, and 21 years or more were considered to be in early, middle, and late career, respectively.
Early career physicians had the lowest satisfaction with overall career choice (being a physician), the highest frequency of work-home conflicts, and the highest rates of depersonalization (all P<.001). Physicians in middle career worked more hours, took more overnight calls, had the lowest satisfaction with their specialty choice and their work-life balance, and had the highest rates of emotional exhaustion and burnout (all P<.001). Middle career physicians were most likely to plan to leave the practice of medicine for reasons other than retirement in the next 24 months (4.8%, 12.5%, and 5.2% for early, middle, and late career, respectively). The challenges of middle career were observed in both men and women and across specialties and practice types.
Burnout, satisfaction, and other professional challenges for physicians vary by career stage. Middle career appears to be a particularly challenging time for physicians. Efforts to promote career satisfaction, reduce burnout, and facilitate retention need to be expanded beyond early career interventions and may need to be tailored by career stage.
Mayo Clinic Proceedings 12/2013; 88(12):1358-67. DOI:10.1016/j.mayocp.2013.07.016 · 6.26 Impact Factor
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