An emergency medicine physician well-being study focusing on gender differences and years of practice during the COVID-19 pandemic

Physician wellbeing and burnout in emergency medicine in Switzerland

Emergency physicians are the most at-risk medical specialist group for burnout. Given its consequences for patient care and physician health and its resulting increased attrition rates, ensuring the wellbeing of emergency physicians is vital for preserving the integrity of the safety net for the healthcare system that is emergency medicine. In an effort to understand the current state of practicing physicians, this study reviews the results of the first national e-survey on physician wellbeing and burnout in emergency medicine in Switzerland. Addressed to all emergency physicians between March and April 2023, it received 611 complete responses. More than half of respondents met at least one criterion for burnout according to the Maslach Burnout Inventory - Human Services Survey (59.2%) and the Copenhagen Burnout Inventory (54.1%). In addition, more than half reported symptoms suggestive of mild to severe depression, with close to 20% screening positively for moderate to severe depression, nearly 4 times the incidence in the general population, according to the Patient Health Questionnaire-9. We found that 10.8% of respondents reported having considered suicide at some point in their career, with nearly half having considered this in the previous 12 months. The resulting high attrition rates (40.6% of respondents had considered leaving emergency medicine because of their working conditions) call into question the sustainability of the system. Coinciding with trends observed in other international studies on burnout in emergency medicine, this study reinforces the fact that certain factors associated with wellbeing are intrinsic to emergency medicine working conditions.

Burnout in emergency medicine professionals after 2 years of the COVID-19 pandemic: a threat to the healthcare system?

BACKGROUND

Burnout is a common problem among healthcare professionals (HCPs), in particular young doctors and nurses working in emergency medical services. The coronavirus disease 2019 (COVID-19) pandemic has generated a substantial increase in the workload of those working in front-line services, and there is evidence of physical and mental distress among professionals that may have caused an increase in burnout.

OBJECTIVE

The objective of the study was to evaluate the level of burnout in the different professionals of emergency medical services.

DESIGN AND PARTICIPANTS

In January and February 2022, we conducted an online survey based on the Abbreviate Maslach inventory with the addition of three questions focused on possible modifying factors. The survey was disseminated to HCP via the list of European Society for Emergency Medicine contacts.

OUTCOME MEASURES

The analysis was based on two of the three elements of the Maslach burnout concept, 'depersonalisation', 'emotional exhaustion', and 'personal accomplishment'. Overall burnout was defined when at least one of the two elements 'depersonalisation' or 'emotional exhaustion' reached the level of high burnout.

RESULTS

The number of responders was 1925, 84% of which were physicians, 12% nurses, and 2% paramedics. Burnout was present in 62% of all responders. A high burnout level was reported for depersonalisation, emotional exhaustion, and personal accomplishment in 47%, 46%, and 48% of responders, respectively. Females reported a higher proportion of burnout compared with males 64% vs. 59%, difference -6% [95% confidence interval CI, -8 to -1.9], and nurses higher than physicians, 73% vs. 60%, difference -13 (95% CI, -18.8 to -6). Less experienced professionals reported higher levels of burnout: those with less than 5 years of experience the burnout level was 74% compared with the group with more than 10 years, 60%, difference -26% (95% CI, -32 to -19.5). Reported frequent understaffing situations were associated with a higher risk of burnout: 70% vs. 37%, difference -33% (95% CI, -41 to -25). Burnout was associated with a higher risk of desire to change the workplace: 87% vs. 40%, difference -47% (95% CI, -52 to -42). Survey responders reported having access to support programmes in 41% of cases.

CONCLUSION

In this study, there is a high reported level of burnout among emergency HCPs. Several risk factors were identified such as being understaffed, female, or having less experience. HCPs with burnout thought more frequently about leaving the workplace, posing a threat to healthcare systems.