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Frintner MP, Leslie LK, Gottschlich EA, Starmer AJ, Byrne BJ, Freed GL. Pediatricians' Career Satisfaction and Wellbeing by Sex Before and During the COVID-19 Pandemic. Pediatrics 2024; 153:e2023063345. [PMID: 38384232 DOI: 10.1542/peds.2023-063345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVE To compare pediatrician career satisfaction and wellbeing by sex during the coronavirus disease 2019 pandemic with prepandemic years using longitudinal survey data. METHODS Data from a cohort study, the American Academy of Pediatrics Pediatrician Life and Career Experience Study, were used to examine career satisfaction and wellbeing from 2012 to 2021 among 2002-2004 and 2009-2011 residency graduates (n = 1760). Mixed effects logistic regression, including key pediatrician characteristics, examined career satisfaction and wellbeing measures for sex (female vs male), pandemic year (2012-2019 vs 2020-2021), and their interaction effect. Adjusted predicted percentage values (PVs) were determined. RESULTS In total, 73.4% of participants identified as female. Adjusting for key pediatrician characteristics, differences were found by sex for satisfaction and 4 of 5 wellbeing measures, by pandemic year for 2 wellbeing measures, and the interaction of sex and pandemic year for 3 wellbeing measures. Female pediatricians reported higher levels of anxiety, sadness, and work stress, with greater differences during the pandemic. For example, female pediatricians (PV = 22.6, confidence interval [CI] = 21.0-24.3) were more likely than male pediatricians (PV = 14.2, CI = 12.0-16.4) to report anxiety during pre-pandemic years, and the difference between female pediatricians (PV = 29.3, CI = 26.7-32.0) and male pediatricians (PV = 12.4, CI = 9.3-15.5) increased during pandemic years (sex by pandemic year interaction, P < .001). CONCLUSIONS Compared with male pediatricians, female pediatricians reported worse anxiety, sadness, and stress at work, and the differences were more pronounced during the pandemic.
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Affiliation(s)
| | | | | | - Amy J Starmer
- Baystate Children's Hospital, Springfield, Massachusetts
| | - Bobbi J Byrne
- Indiana University School of Medicine, Indianapolis, Indiana
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Webber S, Semia S, Nacht CL, Garcia S, Kloster H, Vellardita L, Kieren MQ, Kelly MM. Physician Work-Personal Intersection: A Scoping Review of Terms, Definitions, and Measures. Acad Med 2024; 99:331-339. [PMID: 38039978 DOI: 10.1097/acm.0000000000005579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
PURPOSE A substantial body of evidence describes the multidimensional relationship between the intersection of physicians' work and personal lives and health care quality and costs, workforce sustainability, and workplace safety culture. However, there is no clear consensus on the terms, definitions, or measures used in physician work-personal intersection (WPI) research. In this scoping review, the authors aimed to describe the terms and definitions used by researchers to describe physician WPI, summarize the measurement tools used, and formulate a conceptual model of WPI that can inform future research. METHOD The authors searched PubMed, CINAHL, Scopus, and Web of Science for studies that investigated U.S. practicing physicians' WPI and measured WPI as an outcome from January 1990 to March 2022. The authors applied thematic analysis to all WPI terms, definitions, and survey questions or prompts in the included studies to create a conceptual model of physician WPI. RESULTS Ultimately, 102 studies were included in the final analysis. The most commonly used WPI terms were work-life balance, work-life integration, and work-home or work-life conflict(s). There was no consistency in the definition of any terms across studies. There was heterogeneity in the way WPI was measured, and only 8 (7.8%) studies used a validated measurement tool. The authors identified 6 key driver domains of WPI: work and personal demands; colleague and institutional support and resources; personal identity, roles, health, and values; work schedule and flexibility; partner and family support; and personal and professional strategies. CONCLUSIONS The authors found significant variability in the terms, definitions, and measures used to study physician WPI. They offer a conceptual model of the WPI construct that can be used to more consistently study physician WPI in the future. Future work should further investigate the validity of this model and generate consensus around WPI terms, definitions, and measures.
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Abstract
Approximately 30 million ill and injured children annually visit emergency departments (EDs) in the United States. Data suggest that patients seen in pediatric EDs by board-certified pediatric emergency medicine (PEM) physicians receive higher-quality care than those cared for by non-PEM physicians. These benefits, coupled with the continued growth in PEM since its inception in the early 1990s, have impacted child health broadly. This article is part of a Pediatrics supplement focused on predicting the future pediatric subspecialty workforce supply by drawing on the American Board of Pediatrics workforce data and a microsimulation model of the future pediatric subspecialty workforce. The article discusses the utilization of acute care services in EDs, reviews the current state of the PEM subspecialty workforce, and presents projected numbers of PEM subspecialists at the national, census region, and census division on the basis of this pediatric subspecialty workforce supply model through 2040. Implications of this model on education and training, clinical practice, policy, and future workforce research are discussed. Findings suggest that, if the current growth in the field of PEM continues on the basis of the increasing number and size of fellowship programs, even with a potential reduction in percentage of clinical time and attrition of senior physicians, the PEM workforce is anticipated to increase nationally. However, the maldistribution of PEM physicians is likely to be perpetuated with the highest concentration in New England and Mid-Atlantic regions and "PEM deserts" in less populated areas.
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Affiliation(s)
- Maya S Iyer
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio
- Nationwide Children's Hospital, Columbus, Ohio
| | - Joshua Nagler
- Department of Pediatrics, Harvard Medical School/Boston Children's Hospital, Boston, Massachusetts
| | - Richard B Mink
- The Lundquist Institute for Biomedical Innovation at Harbor, University of California Los Angeles Medical Center, Torrance, California
| | - Javier Gonzalez Del Rey
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Obina WF, Ndibazza J, Kabanda R, Musana J, Nanyingi M. Factors associated with perceived work-life balance among health workers in Gulu District, Northern Uganda: a health facility-based cross-sectional study. BMC Public Health 2024; 24:278. [PMID: 38263074 PMCID: PMC10807176 DOI: 10.1186/s12889-024-17776-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024] Open
Abstract
INTRODUCTION Work-life balance (WLB) plays a significant role in improving career satisfaction and reducing burnout. While health workers' productivity is considered a key factor in client care, there is limited effort put into examining how health workers perceive the balance of their jobs with family and other societal responsibilities (PWLB), especially in low-income countries where the number of health workers in active patient care is low. The purpose of this study was to assess factors associated with perceived work-life balance (PWLB) among health workers in the rural district of Gulu, Northern Uganda. METHODS A health facility-based cross-sectional analytical study was conducted. A simple random sampling technique was used to select 384 study participants from the three main hospitals in Gulu District. Data were collected from health workers using a self-administered semi-structured questionnaire and analyzed using STATA version 15. Factors associated with PWLB were determined at a multivariable level using a modified Poisson regression with robust variance with a 95% confidence level and 5% statistical significance. Adjusted prevalent ratios (APR) were used to report the Factors associated with PWLB. RESULTS Only 157/384 (40.9%) of the health workers reported a positive perceived work-life balance. Multivariable modified Poisson regression analysis showed positive statistical association with PWLB of a laboratory worker(APR = 1.74, 95% CI: 1.10-2.75); a midwife(APR = 1.82, 95% CI:1.13-2.93) or a nurse (APR = 2.19, 95% CI = 1.45-3.30); working in the inpatient department (APR = 1.97, 95% CI: 1.31-2.96) or laboratory (APR = 2.09, 95%CI: 1.34-3.28); and having a flexible work schedule (APR = 28.32, 95%CI:14.52-55.22); feeling satisfied at work (APR = 1.58; 95% CI:1.17-2.10), and belonging to an association in the community (APR = 32.71, 95% Cl:11.91-89.88). On the other hand, employment tenure of 1-4 years (APR = 0.63,95% CI:0.40-0.99) was negatively associated with perceived work-life balance. CONCLUSION Only four in every 10 health workers experienced a positive perceived work-life balance. The type of profession, duty station, flexibility in work schedule, satisfaction with work, and availability of social support systems, were independent determinants of perceived WLB. Therefore, nurturing a system of reviews of the scheduling of health workers, allowing internal staff rotation, and fostering support systems around the health workers could be beneficial for WLB.
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Affiliation(s)
- Wilfred Felicity Obina
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Kampala, P.O Box 5498, Uganda
- Department of Health, Catholic Medical Services, Gulu District, Kampala, Uganda
| | - Juliet Ndibazza
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Kampala, P.O Box 5498, Uganda
| | - Richard Kabanda
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Kampala, P.O Box 5498, Uganda
| | - Jonathan Musana
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Kampala, P.O Box 5498, Uganda
| | - Miisa Nanyingi
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Kampala, P.O Box 5498, Uganda.
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Webber S, Coller RJ, Schultz R, Rogers EE, Olson ME, Moreno MA, Babal JC. Eight Domains of Pediatrician Wellness: A Stakeholder Informed Model. Acad Pediatr 2024:S1876-2859(23)00480-1. [PMID: 38215902 DOI: 10.1016/j.acap.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Physician wellness is important to health care systems and quality patient care. There has been limited research clarifying the physician wellness construct. We aimed to develop a stakeholder-informed model of pediatrician wellness. METHODS We performed a group concept mapping (GCM) study to create a model of pediatrician wellness. We followed the four main steps of GCM and recruited pediatricians at multiple sites and on social media. During brainstorming, pediatricians individually responded to a prompt to generate ideas describing the concept of pediatrician wellness. Second, pediatricians sorted the list of brainstormed ideas into conceptually similar groups and rated them on importance. Sorted data were analyzed to create maps showing each idea as a point, with lines around groups of points to create clusters of wellness. Mean importance scores for each cluster were calculated and compared using pattern match. RESULTS Pediatricians in this study identified eight clusters of wellness: 1) Experiencing belonging and support at work, 2) Alignment in my purpose, my work, and my legacy, 3) Feelings of confidence and fulfillment at work, 4) Skills and mindset for emotional well-being, 5) Harmony in personal, professional, and community life, 6) Time and resources to support holistic sense of self, 7) Work boundaries and flexibility, and 8) Organizational culture of inclusion and trust. There were no significant differences in mean cluster rating score; the highest rated cluster was Harmony in personal, professional and community life (3.62). CONCLUSION Pediatricians identified eight domains of wellness, spanning professional and personal life, work, and individual factors.
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Affiliation(s)
- Sarah Webber
- Department of Pediatrics (S Webber, RJ Coller, R Schultz, MA Moreno, and JC Babal), University of Wisconsin School of Medicine and Public Health, Madison, Wis.
| | - Ryan J Coller
- Department of Pediatrics (S Webber, RJ Coller, R Schultz, MA Moreno, and JC Babal), University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Roger Schultz
- Department of Pediatrics (S Webber, RJ Coller, R Schultz, MA Moreno, and JC Babal), University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Elizabeth E Rogers
- Department of Pediatrics (EE Rogers), University of California San Francisco
| | - Maren E Olson
- Department of Pediatrics (ME Olson), University of Minnesota, Minneapolis, Minn
| | - Megan A Moreno
- Department of Pediatrics (S Webber, RJ Coller, R Schultz, MA Moreno, and JC Babal), University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Jessica C Babal
- Department of Pediatrics (S Webber, RJ Coller, R Schultz, MA Moreno, and JC Babal), University of Wisconsin School of Medicine and Public Health, Madison, Wis
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Skotnicki BS, Wilson PM, Kazmerski TM, Prideaux J, Manole MD, Kinnane JM, Lunoe MM. Work-Life Integration for Women in Pediatric Emergency Medicine: Themes Identified Through Group Level Assessment. Pediatr Emerg Care 2024; 40:71-75. [PMID: 38157398 DOI: 10.1097/pec.0000000000003106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Women in medicine generally have higher burnout and lower career satisfaction and work-life integration compared with men. This study identifies factors that contribute to burnout, career satisfaction, and work-life integration in women pediatric emergency medicine (PEM) physicians. METHODS Self-identified women PEM physicians in the United States participated in a virtual focus group using Group Level Assessment methodology. Participants completed Group Level Assessment process steps of climate setting, generating, appreciating, reflecting, understanding, selecting, and action to (1) identify themes that contribute to burnout, career satisfaction, and work-life integration and (2) determine actionable factors based on these themes. Data were collected and thematically analyzed in real time through iterative processing. The group prioritized identified themes through rounds of distillation. RESULTS Seventeen women participated, representing 10 institutions (ages 30s-70s, 69% employed full-time). Participants identified 3 main themes contributing to burnout, career satisfaction, and work-life integration: (1) gender inequities, (2) supportive leadership, and (3) balance with family life. Actionable items identified were as follows: (1) development of initiatives to equalize pay, opportunity, and career advancement among genders; (2) implementation of an institutional focus on supportive and collaborative leadership; and (3) improvement of resources and supports for physicians with family responsibilities. CONCLUSIONS Women PEM physicians identified gender inequities, leadership, and balance with family life as major themes affecting their burnout, career satisfaction, and work-life integration. Several action steps were identified and can be used by individuals and institutions to improve work-life integration for women PEM physicians.
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Affiliation(s)
- Brielle Stanton Skotnicki
- From the Division of Emergency Medicine, Department of Pediatrics, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Paria M Wilson
- Department of Pediatrics, University of Cincinnati College of Medicine; Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Traci M Kazmerski
- Division of Adolescent and Young Adult Medicine, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | | | - Mioara D Manole
- From the Division of Emergency Medicine, Department of Pediatrics, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Janet M Kinnane
- From the Division of Emergency Medicine, Department of Pediatrics, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Maren M Lunoe
- From the Division of Emergency Medicine, Department of Pediatrics, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
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Fu MM, Fu MW, Chen RY, Chan HL, Lee TSH, Fu E. Life satisfaction and peace of mind among dentists: a cross-sectional study. Clin Oral Investig 2023; 27:6421-6428. [PMID: 37726487 DOI: 10.1007/s00784-023-05245-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVES This study sought to identify the factors associated with the life satisfaction and peace of mind (PoM) of dentists not in full-time clinical training. MATERIALS AND METHODS Cross-sectional questionnaires were distributed to dentists in Taiwan to collect their life satisfaction, PoM, sociodemographic data, and dental career-related characteristics. Life satisfaction was measured using a 5-item Satisfaction with Life Scale. PoM was measured using a 7-item Peace of Mind Scale. Descriptive statistics and multiple linear regression models were estimated to explore potential associations between the two scales and the examined factors. RESULTS A total of 1196 dentists (45.6% female; mean age = 44.12) completed the questionnaires. The response rate of completed questionnaires from email invitations was 32.9%. On multivariable analysis, life satisfaction and PoM were associated with age (b = 0.008 in both), better perceived health (b = 0.262 and 0.308, respectively), family interaction (b = 0.264 and 0.207, respectively), and friend relationships (b = 0.076 and 0.091, respectively). Being married (b = 0.191), being specialized (b = 0.127), working in private practice, and spending 10 to 39 h per week with patients (b = 0.101 to 0.162) were associated with a higher level of life satisfaction but not PoM. CONCLUSIONS Specialists working in private practice without working overtime were associated with better life satisfaction. However, the dentists' health and relationships with family were more related to their subjective well-being than their professional achievements. CLINICAL RELEVANCE Our findings can help policymakers increase awareness of the well-being of general dentists and those in academia or hospitals to promote their mental health.
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Affiliation(s)
- Martin M Fu
- Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Min-Wen Fu
- Department of Endodontics, New York University College of Dentistry, New York, NY, USA
| | - Rebecca Y Chen
- Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Dentistry, Taipei Tzu Chi Hospital, New Taipei City, Taiwan
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- Division of Periodontology, The Ohio State University College of Dentistry, Columbus, OH, USA
| | - Tony Szu-Hsien Lee
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Earl Fu
- Department of Dentistry, Taipei Tzu Chi Hospital, New Taipei City, Taiwan.
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Martin SR, Heyming T, Morphew T, Sayrs L, Fortier MA, Sanger T, Kain ZN. Impact of COVID-19 pandemic on pediatric healthcare burnout in acute care: a longitudinal study. Pediatr Res 2023; 94:1771-1778. [PMID: 37301924 PMCID: PMC10257162 DOI: 10.1038/s41390-023-02674-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/12/2023] [Accepted: 05/08/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND COVID-19 pandemic introduced significant challenges that may have exacerbated healthcare worker (HCW) burnout. To date, assessments of burnout during COVID-19 pandemic have been cross-sectional, limiting our understanding of changes in burnout. This longitudinal study assessed change across time in pediatric HCW burnout during the COVID-19 pandemic and whether demographic and psychological factors were associated with changes in burnout. METHODS This longitudinal study included 162 physicians, physician assistants, nurses, and medical technicians within the emergency department (ED), intensive care, perioperative, and inter-hospital transport services in a children's hospital. HCW demographics, anxiety and personality traits were reported via validated measures. HCWs completed the Maslach Burnout Inventory in April 2020 and March 2021. Data were analyzed using generalized estimating equations. RESULTS The percentage of HCWs reporting high emotional exhaustion and/or depersonalization burnout increased significantly across time (18.5% to 28.4%, P = 0.010). Factors associated with increased emotional exhaustion included working in the ED (P = 0.011) or perioperative department (P < 0.001), being a nurse or medical technician (P's < 0.001), not having children (P < 0.001), and low conscientiousness (P < 0.001). CONCLUSIONS Pediatric HCW burnout significantly increased over 11-months of the COVID-19 pandemic. Results suggest that certain demographic and psychological factors may represent potential area to target for intervention for future pandemics. IMPACT This longitudinal study revealed that the COVID-19 pandemic has had a significant impact on pediatric healthcare worker burnout. The percentage of healthcare workers reporting high levels of emotional exhaustion and depersonalization burnout increased significantly over 11-months of the COVID-19 pandemic. Results suggest that certain demographic and psychological factors may represent potential targets for future interventions.
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Affiliation(s)
- Sarah R Martin
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, Irvine, CA, USA
- Center on Stress & Health, University of California, Irvine, Irvine, CA, USA
- Children's Hospital of Orange County, Orange, CA, USA
| | - Theodore Heyming
- Children's Hospital of Orange County, Orange, CA, USA
- Emergency Medicine, University of California, Irvine, Irvine, CA, USA
| | - Tricia Morphew
- Morphew Consulting, LLC, Bothell, WA, USA
- Research Institute, Children's Hospital of Orange County, Orange, CA, USA
| | - Lois Sayrs
- Children's Hospital of Orange County, Orange, CA, USA
- University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Michelle A Fortier
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, Irvine, CA, USA
- Center on Stress & Health, University of California, Irvine, Irvine, CA, USA
- Children's Hospital of Orange County, Orange, CA, USA
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, USA
| | | | - Zeev N Kain
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, Irvine, CA, USA.
- Center on Stress & Health, University of California, Irvine, Irvine, CA, USA.
- Children's Hospital of Orange County, Orange, CA, USA.
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Skotnicki BS, Wilson PM, Kazmerski TM, Manole MD, Kinnane JM, Lunoe MM. Gender Differences in Work-Life Integration, Career Satisfaction, and Burnout in Pediatric Emergency Medicine Physicians: A Cross-Sectional Analysis. Pediatr Emerg Care 2023:00006565-990000000-00346. [PMID: 37857469 DOI: 10.1097/pec.0000000000003055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Women physicians report worse work-life integration, career satisfaction, and burnout than men. No studies have evaluated work-life integration and career satisfaction in pediatric emergency medicine (PEM) or explored gender differences for these outcomes. This study aims to (1) compare work-life integration, career satisfaction, and burnout in women and men PEM physicians and (2) compare associated individual and occupational factors to distinguish modifiable factors. METHODS We distributed an electronic survey to assess well-being parameters in PEM physicians. We assessed career satisfaction and work-life integration with single-item measures. We used a 2-item screen to measure burnout. We performed descriptive analyses, univariate analysis to compare gender differences, and multivariate logistic regression analysis for each outcome. RESULTS Two hundred thirty-nine PEM physicians participated, yielding a response rate of 50% (57% women; age range, 30-80 years). Overall satisfaction with work-life integration was 42.9%, with 34.3% of women reporting appropriate work-life integration, compared with 55.4% of men (P = 0.001). Career satisfaction rate was 77.8%, with 71.6% of women reporting career satisfaction, compared with 86.1% of men (P = 0.008). Burnout rate was 44.5%, with 53.7% of women reporting burnout compared with 33.7% of men (P = 0.002). Modifiable factors identified include perception of unfair compensation, inadequate physical and mental health support provided by organization, feeling unappreciated, inadequate provider staffing, inadequate resources for patient care, lack of advance notice or control of work schedule, and inadequate sleep. CONCLUSIONS Of PEM physicians, women have worse work-life integration, less career satisfaction, and more burnout than men. The PEM community should devote resources to modifiable occupational factors to improve gender disparities in well-being parameters.
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Affiliation(s)
- Brielle Stanton Skotnicki
- From the Division of Emergency Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA
| | | | - Traci M Kazmerski
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA
| | - Mioara D Manole
- From the Division of Emergency Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA
| | - Janet M Kinnane
- From the Division of Emergency Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA
| | - Maren M Lunoe
- From the Division of Emergency Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA
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Sapienza M, Furia G, La Regina DP, Grimaldi V, Tarsitano MG, Patrizi C, Capelli G, Damiani G. Primary care pediatricians and job satisfaction: a cross sectional study in the Lazio region. Ital J Pediatr 2023; 49:104. [PMID: 37626394 PMCID: PMC10463623 DOI: 10.1186/s13052-023-01511-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The Order of Physicians and Dentists of the Province of Rome aims at focusing on the satisfaction of healthcare personnel as an essential factor for the quality of medical care in the health sector. The aim of this study is to assess and prioritize the factors that can be linked to a higher or lower degree of job satisfaction in Primary Care Pediatricians (PCPs). METHODS This study is a cross sectional survey. A questionnaire was administered to all primary care pediatricians registered to the Order, exploring in particular the work activity organization, the level of satisfaction in their professional life, and the level of perceived health. A pilot activity was conducted to validate the questionnaire. Fisher exact test and ordinal logistic regression (ologit) models were used for the univariate and multivariate analysis. RESULTS The highest level of job dissatisfaction, in both men and women, was found to be in the practice type without any form of association; among women, it reached an even higher level for those who had their own practice at a distance of 20-40 km from their home. Women, compared to men, maintained a lower level of job satisfaction also while working in Pediatric Primary Care Units (PPCUs). In PPCUs, for the same distance, females showed a more similar pattern to males. Men working in PPCUs, regardless of distance, declared a higher degree of job satisfaction. Both men and women, working as a group pediatrician or in PPCUs, did not show a significant difference in the level of job satisfaction. CONCLUSIONS The study contributes to a deeper understanding of the factors that may influence levels of career satisfaction in female and male PCPs. Therefore, research and interventions regarding job satisfaction should foster an organizational network connection among PCPs for their job and individual well-being, from a perspective of enhancing patient care. A major effort to improve work-life balance and career satisfaction among women is important, suggesting that interventions for improving job satisfaction could benefit from a gender-specific approach.
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Affiliation(s)
- Martina Sapienza
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy.
| | - Giuseppe Furia
- Hospital Management Area, Local Health Authority Roma 1, Borgo Santo Spirito 3, 00193, Rome, Italy
| | - Domenico Paolo La Regina
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Valentina Grimaldi
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Via Giovanni Battista de Rossi 9, 00161, Rome, Italy
- Primary Care Pediatrician, Local Health Authority Roma 2, Rome, Italy
| | - Maria Grazia Tarsitano
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Via Giovanni Battista de Rossi 9, 00161, Rome, Italy
- Department of Medical and Surgical Sciences, University "Magna Graecia", Viale Europa, 88100, Catanzaro, Italy
| | - Cristina Patrizi
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Via Giovanni Battista de Rossi 9, 00161, Rome, Italy
- General Pratictioner, Legal Medicine Unit, Local Health Authority Roma 2, Rome, Italy
| | - Giovanni Capelli
- National Center for Disease Prevention and Health Promotion, Istituto Superiore Di Sanità (ISS), Viale Regina Elena 299, 00161, Rome, Italy
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Italy
| | - Gianfranco Damiani
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy
- Directive Council of Order of Physicians and Dentists of the Province of Rome, Via Giovanni Battista de Rossi 9, 00161, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario, "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
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11
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Savarimalai R, Christy J, Bhaskarapillai B, Damodharan D, Sekar K. Work-life balance among mental health professionals in a tertiary care neuropsychiatry centre in India. Ind Psychiatry J 2023; 32:354-360. [PMID: 38161471 PMCID: PMC10756616 DOI: 10.4103/ipj.ipj_31_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 01/03/2024] Open
Abstract
Background Stress and distress are common among Mental Health Professionals (MHP). MHPs avoid seeking professional help to address their stress, leading to increased vulnerability to stress and mental health conditions. Inadequately addressed stress directly impacts their service delivery and well-being. However, a serious dearth of literature from India has examined the extent of work-life balance (WLB) stress and psychological distress (PD) among MHP. Aim This cross-sectional study aims to assess WLB and examine the relationship between perceived stress (PS), PD, burnout, and WLB among MHP in a tertiary care neuropsychiatry center. Methods Using stratified random sampling, 101 MHP were evaluated using Pareek's work-life balance scale, Stamm's professional quality of life (ProQoL) scale, WHO's self-reporting questionnaire, and Cohen's perceived stress scale. Data were analyzed using appropriate parametric or non-parametric tests. Results The overall mean score on WLB was 80.45 (SD = 10.21), the PS scale was 24.86 (SD = 6.87), the burnout score was 22.68 (SD = 6), the ST score was 21.18 (SD = 6.35), and PD score was 5.07 (SD = 5.23). The level of WLB score was average to below average among 64% of participants. There is a positive correlation between WLB and compassion satisfaction (CS) and a negative correlation between ST and PS. The study found that the nature of the job, CS, and PD shall predict WLB. Conclusion Stress, burnout, ProQoL, and WLB of MHPs vary significantly by job, income, and staying with family, indicating that MHPs are equally vulnerable to stress and burnout and imbalanced WLB, which require appropriate interventions.
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Affiliation(s)
- Rajamanikandan Savarimalai
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Jayakumar Christy
- Centre for Psychosocial Support in Disaster Management, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Binukumar Bhaskarapillai
- Department of Biostatistics, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Dinakaran Damodharan
- Centre for Psychosocial Support in Disaster Management, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Kasi Sekar
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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12
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Russ CM, Gao Y, Karpowicz K, Lee S, Stephens TN, Trimm F, Yu H, Jiang F, Palfrey J. The Pediatrician Workforce in the United States and China. Pediatrics 2023:191246. [PMID: 37158018 DOI: 10.1542/peds.2022-059143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 05/10/2023] Open
Abstract
From 2019 to 2022, the For Our Children project gathered a team of Chinese and American pediatricians to explore the readiness of the pediatric workforce in each country to address pressing child health concerns. The teams compared existing data on child health outcomes, the pediatric workforce, and education and combined qualitative and quantitative comparisons centered on themes of effective health care delivery outlined in the World Health Organization Workforce 2030 Report. This article describes key findings about pediatric workload, career satisfaction, and systems to assure competency. We discuss pediatrician accessibility, including geographic distribution, practice locations, trends in pediatric hospitalizations, and payment mechanisms. Pediatric roles differed in the context of each country's child health systems and varied teams. We identified strengths we could learn from one another, such as the US Medical Home Model with continuity of care and robust numbers of skilled clinicians working alongside pediatricians, as well as China's Maternal Child Health system with broad community accessibility and health workers who provide preventive care.In both countries, notable inequities in child health outcomes, evolving epidemiology, and increasing complexity of care require new approaches to the pediatric workforce and education. Although child health systems in the United States and China have significant differences, in both countries, a way forward is to develop a more inclusive and broad view of the child health team to provide truly integrated care that reaches every child. Training competencies must evolve with changing epidemiology as well as changing health system structures and pediatrician roles.
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Affiliation(s)
- Christiana M Russ
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Yijin Gao
- Shanghai Children's Medical Center, Shanghai, China
- Shanghai JiaoTong University School of Medicine, Shanghai, China
| | | | - Shoo Lee
- Mount Sinai Hospital, New York City, New York
- University of Toronto, Toronto, Canada
| | - Timothy Noel Stephens
- Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, China
| | - Franklin Trimm
- University of South Alabama College of Medicine, Mobile, Alabama; and
| | - Hao Yu
- Harvard Medical School, Boston, Massachusetts
- Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Fan Jiang
- Shanghai Children's Medical Center, Shanghai, China
- Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Judith Palfrey
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Ramakrishnan S. Being a young pediatric cardiologist in India: Aspirations versus reality. Ann Pediatr Cardiol 2023; 16:163-167. [PMID: 37876957 PMCID: PMC10593286 DOI: 10.4103/apc.apc_127_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 10/26/2023] Open
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Attipoe S, Walker DM, Schweikhart SB, Hefner JL. A qualitative study of the dark and bright sides of physicians' electronic health record work outside work hours. Health Care Manage Rev 2023; 48:140-9. [PMID: 36820608 DOI: 10.1097/HMR.0000000000000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The introduction of electronic health records (EHRs) has contributed considerably to EHR work outside work (WOW) hours for physicians. Prior research has identified the pressures associated with stress resulting from EHR WOW, yet developing a nuanced understanding of how physicians appraise and respond to this stress, and the resulting impacts, remains absent from the literature. PURPOSE Grounded in the technostress model, this study takes a qualitative approach to explore both the pressures and opportunities associated with EHR WOW. METHODS Thematic analysis of data from semistructured interviews was utilized to examine the pressures and opportunities associated with EHR WOW among primary care pediatricians (n = 15) affiliated with a large Midwestern pediatric health system. RESULTS The physicians in this study regularly spent time working in the EHR outside work hours. They felt the EHR contributed to their documentation burden, which ultimately increased their EHR WOW, and reported a sense of burden from ubiquitous EHR availability. Conversely, they appreciated the flexibility the EHR provided in terms of work-life balance. Suggestions for improvement under the direct purview of practice management included enhanced EHR usability, improvements in workflow during work hours to free up time to document, and more training on both EHR documentation strategies and ongoing software upgrades. CONCLUSION Physicians perceive that the EHR exerts certain pressures while affording new opportunities and conveniences. This study provides evidence of both the pressures and opportunities of EHR WOW and their effect on physician well-being. PRACTICE IMPLICATIONS Specific opportunities are identified for health administrators to enable physicians to better manage EHR WOW.
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15
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Barshied CB, Russell C. Satisfaction, Stress, and Turnover: Comparing U.S. Intensivist Physicians Before and During the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic. Crit Care Explor 2023; 5:e0883. [PMID: 36910456 PMCID: PMC9997802 DOI: 10.1097/cce.0000000000000883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
To evaluate changes in work satisfaction, work-life balance (WLB) satisfaction, stress, and turnover intention among U.S. critical care physicians during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic of 2021-2022 compared with prepandemic levels in 2016. DESIGN A cross-sectional electronic survey. SETTING Critical care practices in the United States. SUBJECTS U.S. physician members of the Society for Critical Care Medicine. MEASUREMENTS AND MAIN RESULTS A total of 1,148 intensivists completed online surveys administered in two waves: in 2016 (693 respondents) and in the late 2021 to early 2022 (455 respondents). They reported demographic and practice characteristics, self-perceived levels of satisfaction, stress, health, and intention to leave their current job. U.S.-based critical care physicians in 2022 report significantly lower levels of job satisfaction compared with 2016. Frequency of work stress and turnover intention also increased, whereas WLB satisfaction has remained the same. Nearly two-thirds of intensivists wish they could work fewer hours, and this discontentment is correlated with decreased satisfaction, increased stress, and increased turnover, particularly in pandemic respondents. More than 25% of physicians rated their mental health as poor or fair, and 20% rated their physical health as poor or fair; these self-ratings correlated with decreased satisfaction and increased stress and turnover intention. CONCLUSIONS The SARS-CoV-2 pandemic has further burdened an already-strained critical care workforce. During the pandemic, job satisfaction fell, work stress became more frequent, and turnover intention increased for critical care physicians. They also have consistently low rates of WLB satisfaction. Work hours matter the most for physician satisfaction, stress, and turnover intention, and the desire to work fewer hours is negatively related to all outcomes. Many critical care physicians reported poor mental and physical health during the pandemic, which is strongly and negatively related to all outcomes. These results emphasize the importance of prioritizing the working preferences and the self-care of intensivist physicians.
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Affiliation(s)
| | - Cortessa Russell
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
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16
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Webber SA, Byrne BJ, Starmer AJ, Somberg CA, Frintner MP. Examining Early Career Pediatrician Characteristics, Sacrifices, and Satisfaction. Acad Pediatr 2023; 23:587-596. [PMID: 36682450 DOI: 10.1016/j.acap.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Explore relationships between pediatrician characteristics, sacrifices made for career, and career and life satisfaction. METHODS Surveys of early career pediatricians (ECPs) who recently graduated residency (2016-18), as part of the AAP Pediatrician Life and Career Experience Study (PLACES) were administered in 2019. Logistic regression analyzed association of pediatrician characteristics with personal sacrifices (a lot vs some or no sacrifices) made for one's career and whether career was worth the sacrifices made to become a physician, and association of characteristics and sacrifices with overall career and life satisfaction. RESULTS Of 918 ECPs in the cohort, 90% responded to the 2019 survey. Seventy-seven percent agreed their career was worth the sacrifices and 40% reported they made a lot of personal sacrifices for their career. In multivariable analysis, female sex was associated with lower odds of viewing career as worth the sacrifices made [adjusted odds ratio [aOR] 0.45; 95% confidence interval [CI], 0.28-0.71], a higher odds of delaying starting a family [aOR 2.25; CI, 1.32-3.86] and making sacrifices in having children for career [aOR 2.60; CI, 1.48-4.58]. Those in fellowship training also reported making more sacrifices related to having children for their career [aOR 1.73; CI, 1.08-2.78]. ECPs who reported making a lot of sacrifices for their career were less likely to be satisfied with their overall career and life. CONCLUSIONS Most ECPs believe their sacrifices to become a pediatrician were worth it. Female pediatricians were less likely to feel personal sacrifices were worth it and reported more sacrifices related to having children.
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Affiliation(s)
- Sarah A Webber
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health (SA Webber), Madison, Wis.
| | - Bobbi J Byrne
- Section of Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University School of Medicine (BJ Byrne), Indianapolis, Ind
| | - Amy Jost Starmer
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School (AJ Starmer), Boston, Mass
| | - Chloe A Somberg
- Department of Research, American Academy of Pediatrics (CA Somberg and MP Frintner), Itasca, Ill
| | - Mary Pat Frintner
- Department of Research, American Academy of Pediatrics (CA Somberg and MP Frintner), Itasca, Ill
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Crowe L, Young Am J, Smith AC, Vitangcol K, Haydon HM. Critical care staff wellbeing: A new paradigm for understanding burnout. Aust Crit Care 2023; 36:59-65. [PMID: 36437163 DOI: 10.1016/j.aucc.2022.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/23/2022] [Accepted: 10/23/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The wellbeing of paediatric intensive care unit (PICU) staff members influences their engagement with work and the quality of care they provide to patients. Baseline burnout measures in research provide inconclusive evidence of the determinants of burnout and how to target interventions to promote staff wellbeing. OBJECTIVES The objectives of this study were to determine the prevalence of burnout using the Maslach Burnout Inventory (MBI) burnout-engagement workplace profiles in a sample of Australian PICU staff and investigate associations between demographic characteristics, meaningful work, satisfaction with life, and psychological distress on burnout. METHODS A cross-sectional survey was administered to a multidisciplinary sample of PICU staff (target n = 464) from three tertiary paediatric hospitals in Australia. The survey tool was comprised of the MBI, Work and Meaning Inventory, Satisfaction with Life Scale, Kessler Psychological Distress Scale, and demographic questions. Hierarchical multiple regressions examined the relationships between burnout and these variables of interest. RESULTS A sample of 258 participants (56%) completed the survey. For most respondents, burnout was scored as a low to moderate risk, with over half the participants scoring low risk for emotional exhaustion (EE) (56%) and depersonalisation (DP) (54%). Personal accomplishment (PA) was more evenly distributed (range of burnout risk: low, 32%; moderate, 32%; high, 36%). MBI scores were classified using the burnout-engaged workplace profile system, identifying low levels of burnout (8% burnout, 3% disengaged, 21% overextended, 29% ineffective, and 39% engaged). Psychological distress significantly increased burnout risk across all three dimensions EE (β = 0.253, p < 0.001), DP (β = 0.145, p < 0.05), and PA (β = -0.13, p < 0.05), and being aged between 41 and 55 years was protective of depersonalisation (β = -0.214, p < 0.05). CONCLUSION Utilising MBI workplace profiles, this study has built upon the demand for a more comprehensive assessment of burnout. Research that helps improve our understanding of contributory factors to burnout and wellbeing will inform the development of effective interventions that promote wellbeing of staff.
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Chien KA, Thomas C, Cooley V, Weinstein T, Murray KF, Muir L, Hayes C, Gold BD, Gerber LM, Sauer CG, Tomer G. Physician Burnout in Pediatric Gastroenterology. J Pediatr Gastroenterol Nutr 2023; 76:25-32. [PMID: 36574001 DOI: 10.1097/MPG.0000000000003635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Physicians are prone to burnout which can negatively affect the quality of patient care and lead to medical errors. Burnout can also affect physicians by impacting their personal relationships, their sense of career fulfillment, and job satisfaction. The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) formed a taskforce to investigate burnout among pediatric gastroenterologists. METHODS A 35-item electronic survey was developed to collect demographic and practice information and characterize the well-being of pediatric gastroenterologists. Burnout was assessed employing 2 single-item measures adapted from the Maslach Burnout Inventory. The survey was distributed to NASPGHAN members 3 times from February 2020 to March 2020. Descriptive statistics, Chi-square, and Fisher exact tests were used. RESULTS One thousand seven hundred ninety-one e-mails were successfully sent and 408 participants (22.7%) returned surveys. A total of 28.8% reported high risk for emotional exhaustion, 17.5% reported high risk for depersonalization, and 33% reported overall burnout. Participants 44 years of age or younger reported significantly more burnout than those 45 years and older ( P = 0.018). Contributors to high burnout identified included increased patient load/demands, insufficient nursing support, electronic health record (EHR) use, insufficient administrative staff, excessive on-call coverage, and more complex patients. Forty-four percent reported not having enough time for their personal life including family. A total of 16.2% of participants reported that they would not choose to be a pediatric gastroenterologist again. CONCLUSIONS Pediatric gastroenterologists are at risk for emotional exhaustion, depersonalization, and overall burnout. Strategies to prevent physician burnout should be implemented as soon as feasibly possible to improve individual mental health and patient care.
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19
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Martin SR, Fortier MA, Heyming TW, Ahn K, Nichols W, Golden C, Saadat H, Kain ZN. Perfectionism as a predictor of physician burnout. BMC Health Serv Res 2022; 22:1425. [PMCID: PMC9703407 DOI: 10.1186/s12913-022-08785-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 11/03/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Burnout is common among physicians and has detrimental effects on patient care and physician health. Recent editorials call attention to perfectionism in medicine; however, no studies to date have examined the effect of perfectionism on burnout in physicians practicing in the United States. This study examined associations among demographics, perfectionism and personality traits, and burnout among practicing physicians.
Methods
This cross-sectional study included general pediatric and pediatric sub-specialist physicians. Out of the 152 physicians contacted, 69 enrolled (Meanage = 44.16 ± 9.98; 61% female). Emotional exhaustion, depersonalization, and personal accomplishment burnout were assessed via the Maslach Burnout Inventory. Validated instruments were used to measure personality and perfectionism. Data were analyzed using linear regression models.
Results
Across physicians assessed, 42% reported either high emotional exhaustion burnout or depersonalization burnout. High self-critical perfectionism uniquely predicted both high emotional exhaustion burnout (B = 0.55, 95%CI 0.25–0.85) and depersonalization burnout (B = 0.18, 95%CI 0.05–0.31). Low conscientiousness (B = -6.12; 95%CI, -10.95- -1.28) predicted higher emotional exhaustion burnout and low agreeableness (B = -3.20, 95%CI -5.93- -0.46) predicted higher depersonalization burnout.
Conclusions
Perfectionism is understudied among physicians and the current findings suggest that addressing system and individual-level factors that encourage perfectionism is warranted and may reduce risk for physician burnout.
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Khaja MS, Contrella BN, Wilkins LR, Pyne R, Majdalany BS, Rajebi R, Saad WE, Findeiss L. Issues Most Pressing to Early-Career Interventional Radiologists: Results of a Descriptive Survey. Acad Radiol 2022; 29:1730-1738. [PMID: 33726963 DOI: 10.1016/j.acra.2021.02.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/14/2021] [Accepted: 02/24/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine demographics, practice patterns, needs from Society of Interventional Radiology (SIR), and preferences of interventional radiologists (IRs) early in their careers. METHODS A 28-question descriptive survey was used to identify demographic and practice composition, practice issues, and needs of early career IRs. The survey was distributed to SIR members in the United States (US) (n = 859) within the first 8 years of practice, with 213 respondents (25%). RESULTS Respondents were primarily male (n = 181, 87%), less than 40 years old (n = 156, 73%), in practice for 6 years or less (n = 167, 79%), and satisfied with IR as a career (n = 183, 92.4%). The majority were in academic practice (n = 89, 43.2%) or large private practice group (n = 67, 32.5%). Most respondents read diagnostic imaging daily or weekly (n = 130, 61%). The majority of respondents perform complex procedures regularly including transarterial tumor therapy, percutaneous tumor ablation, peripheral arterial interventions, and biliary interventions monthly. Many respondents (n = 49, 23%) have changed jobs at least once citing career advancement, practice issues/disagreements, or compensation as reason. Most respondents would serve as mentors (n = 170, 80%) for trainees and were satisfied with their career mentorship (n = 166, 78%). Respondents felt that mentorship, identification of barriers facing early career IRs, and networking should be the most important functions of the Early Career Section (ECS)of the SIR. CONCLUSION As nearly all survey respondents indicated that early career IRs have different needs and priorities than established physicians, they felt that mentorship, identification of barriers facing early career IRs, and networking should be the most important functions of the ECS. Additionally, this same group of IRs report low comfort with the business side of medicine and may benefit from directed content provided by the SIR ECS.
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Affiliation(s)
- Minhaj S Khaja
- Division of Vascular and Interventional Radiology, Department of Radiology & Medical Imaging, University of Virginia Health, 1215 Lee St. PO BOX 800700, Charlottesville, VA 22908.
| | - Benjamin N Contrella
- Division of Vascular and Interventional Radiology, Department of Radiology & Medical Imaging, University of Virginia Health, 1215 Lee St. PO BOX 800700, Charlottesville, VA 22908
| | - Luke R Wilkins
- Division of Vascular and Interventional Radiology, Department of Radiology & Medical Imaging, University of Virginia Health, 1215 Lee St. PO BOX 800700, Charlottesville, VA 22908
| | - Raj Pyne
- Rochester Regional Health System; Rochester, New York
| | - Bill S Majdalany
- Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine; Atlanta, Georgia
| | - Reza Rajebi
- Precision Vascular and Interventional Radiology, Dallas, Texas
| | - Wael E Saad
- Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland
| | - Laura Findeiss
- Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine; Atlanta, Georgia
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Abstract
Physician health and wellness is a complex topic relevant to all pediatricians. Survey studies have established that pediatricians experience burnout at comparable rates to colleagues across medical specialties. Prevalence of burnout increased for all pediatric disciplines from 2011 to 2014. During that time, general pediatricians experienced a more than 10% increase in burnout, from 35.3% to 46.3%. Pediatric medical subspecialists and pediatric surgical specialists experienced slightly higher baseline rates of burnout in 2011 and similarly increased to just under 50%. Women currently constitute a majority of pediatricians, and surveys report a 20% to 60% higher prevalence of burnout in women physicians compared with their male counterparts. The purpose of this report is to update the reader and explore approaches to pediatrician well-being and reduction of occupational burnout risk throughout the stages of training and practice. Topics covered include burnout prevalence and diagnosis; overview of national progress in physician wellness; update on physician wellness initiatives at the American Academy of Pediatrics; an update on pediatric-specific burnout and well-being; recognized drivers of burnout (organizational and individual); a review of the intersection of race, ethnicity, gender, and burnout; protective factors; and components of wellness (organizational and individual). The development of this clinical report has inevitably been shaped by the social, cultural, public health, and economic factors currently affecting our communities. The coronavirus disease 2019 (COVID-19) pandemic has layered new and significant stressors onto medical practice with physical, mental, and logistical challenges and effects that cannot be ignored.
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Affiliation(s)
- Hilary H McClafferty
- Department of Pediatrics, Section Chief, Pediatric Emergency Medicine, Tucson Medical Center, Tucson, Arizona
| | - Dena K Hubbard
- Children's Mercy Kansas City, School of Medicine, University of Missouri Kansas City, Kansas City, Missouri
| | - Dana Foradori
- Department of Pediatric Hospital Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | - Melanie L Brown
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Daniel S Tawfik
- Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
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Darboe A, Hawthorne L, Scott A, McGrail M. Exploring life satisfaction difference between domestic and international medical graduates: Evidence from a national longitudinal study. International Journal of Healthcare Management 2022. [DOI: 10.1080/20479700.2022.2130641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Amadou Darboe
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Lesleyanne Hawthorne
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Anthony Scott
- Melbourne Institute, Applied Economic and Social Research, The University of Melbourne, Melbourne, Australia
| | - Matthew McGrail
- Rural Clinical School, University of Queensland, Queensland, Australia
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Byrne BJ, Frintner MP, Starmer AJ, Gottschlich EA, Freed GL. Different Measures and Ways to Categorize Pediatrician Burnout and the Association with Satisfaction. J Pediatr 2022; 249:84-91. [PMID: 35660489 DOI: 10.1016/j.jpeds.2022.05.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/27/2022] [Accepted: 05/27/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Compare pediatrician burnout when measured and categorized in different ways to better understand burnout and the association with satisfaction. STUDY DESIGN We analyzed national survey data from a cohort study of early to midcareer pediatricians. In 2017, participants randomly received 1 of 3 question sets measuring burnout components (emotional exhaustion, depersonalization, and personal accomplishment): group A received the Maslach Burnout Inventory, group B received a previously used measure, and group C received a new severe measure. Repeated measures ANOVA tested differences across burnout categorizations: high emotional exhaustion and high depersonalization and low personal accomplishment; high emotional exhaustion and high depersonalization; and high emotional exhaustion or high depersonalization. Logistic regression tested relationships between burnout profiles (engaged, intermediate, and burnout) and satisfaction. Seventy-one percent of participants completed the survey (1279/1800). RESULTS Burnout varied depending on measurement (groups A, B, and C) and categorization. For example, for group A, when categorized as high emotional exhaustion, high depersonalization, and low personal accomplishment, burnout was lower (4.8%) than categorized as high emotional exhaustion and depersonalization (15.2%) (P < .001) or categorized as high emotional exhaustion or depersonalization (44.6%) (P < .001). Most participants were satisfied with their career (83.6%). Using burnout profiles, 38.4%-85.1% fell in the engaged profile. For each group, burnout profiles were associated with satisfaction. For example, group A participants in the burnout or intermediate profile were less likely than those engaged to be satisfied with their careers (aOR, 0.08 [95% CI, 0.03-0.24]; and aOR, 0.23 [95% CI, 0.10-0.56], respectively). CONCLUSIONS The way burnout is measured and categorized affects burnout prevalence and its association with satisfaction. Transparency in methodology used is critical to interpreting results.
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Affiliation(s)
- Bobbi J Byrne
- Section of Neonatal-Perinatal Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | | | - Amy J Starmer
- Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | | | - Gary L Freed
- Department of Pediatrics, University of Michigan, Ann Arbor, MI
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Fonte C, Barros C, Baylina P, Alves S, Moreira P. Impact of work and personal life conciliation problems on healthcare workers. International Journal of Healthcare Management 2022. [DOI: 10.1080/20479700.2022.2112441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Carla Fonte
- Faculty of Human and Social Sciences, University Fernando Pessoa, Porto, Portugal
| | - Carla Barros
- Faculty of Human and Social Sciences, University Fernando Pessoa, Porto, Portugal
| | - Pilar Baylina
- Health School, Polytechnic Institute of Porto, Porto, Portugal
| | - Sónia Alves
- Faculty of Human and Social Sciences, University Fernando Pessoa, Porto, Portugal
| | - Paulo Moreira
- International Healthcare Management Research and Development Centre, Shandong Province Qianfoshan Hospital, Shandong Medical University first Affiliated Hospital, Jinan, People’s Republic of China
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Bodendieck E, Jung FU, Conrad I, Riedel-heller SG, Hussenoeder FS. The work-life balance of general practitioners as a predictor of burnout and motivation to stay in the profession. BMC Prim Care 2022; 23:218. [PMID: 36042417 PMCID: PMC9429779 DOI: 10.1186/s12875-022-01831-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/24/2022] [Indexed: 12/02/2022]
Abstract
Background Work-life balance (WLB) is associated with a variety of health-related outcomes in the general population. Since General Practitioners (GPs) play a fundamental role in the health system, we wanted to analyze the associations between their WLB and burnout scores as well as motivation to stay in the profession. Methods In September 2019, physicians from various specialties answered a comprehensive questionnaire. We analyzed a subsample of 188 GPs that were working full time, 61.7% were female. Results Multivariate analysis showed a beneficial association between WLB and all three dimensions of burnout (Emotional Exhaustion, Cynicism, and Professional Efficacy) as well as the motivation to stay in the profession. Conclusions Improving GPs WLB could be a way to reduce physician burnout, strengthen the healthcare system, and attract a new generation of talented physicians.
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Hawkins D, Alenó Hernández KM. Racial and ethnic differences in the prevalence of work organization and occupational psychosocial exposures. Am J Ind Med 2022; 65:567-575. [PMID: 35578156 DOI: 10.1002/ajim.23368] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 04/09/2022] [Accepted: 05/03/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUNDS This study sought to assess if there were differences in exposure to job insecurity, shift work, work-life imbalance, workplace harassment, and nonstandard work arrangements according to race and ethnicity in the United States. METHODS Using data from the nationally representative National Health Interview Survey conducted in 2015, we calculated the prevalence of job insecurity, shift work, work-life imbalance, workplace harassment, and nonstandard work arrangements according to race and ethnicity. Using this data, we then modeled the prevalence of these exposures while adjusting for covariates including occupation. RESULTS Compared to non-Hispanic White workers, Hispanic (prevalence ratio [PR] = 1.47, 95% confidence interval [CI] = 1.30, 1.66) and non-Hispanic Asian (PR = 1.57, 95% CI = 1.28, 1.92) workers reported more job insecurity. Non-Hispanic Black workers were more likely to report working in shifts (PR = 1.34, 95% CI = 1.22, 1.46) and Hispanic workers reported being employed in alternative work arrangements (PR = 1.40, 95% CI = 1.23, 1.58) more often than non-Hispanic White workers. Non-Hispanic White workers were slightly more likely to report work-life imbalance and workplace harassment than other races/ethnicities. Occupational segregation accounted for some of the racial/ethnic differences in shift work and alternative work arrangements. CONCLUSIONS These findings are consistent with some previous research on differences in the prevalence of these work organization and psychosocial exposures by race/ethnicity, especially with respect to shift work and alternative work arrangements. However, other studies have found contradictory findings, especially with respect to workplace harassment. There is a need for future research that tackles the association between these exposures and racial/ethnic health disparities.
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Affiliation(s)
- Devan Hawkins
- Public Health Program, School of Arts and Sciences, MCPHS University, Boston, Massachusetts, USA
| | - Karlen M Alenó Hernández
- Public Health Program, School of Arts and Sciences, MCPHS University, Boston, Massachusetts, USA
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Frintner MP, Leslie LK, Gottschlich EA, Starmer AJ, Cull WL. Changes in Work Characteristics and Pediatrician Satisfaction: 2012-2020. Pediatrics 2022; 150:188261. [PMID: 35686476 DOI: 10.1542/peds.2021-055146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To examine the association of changes in pediatricians' work characteristics with their satisfaction using longitudinal data. METHODS Data from a cohort study, the American Academy of Pediatrics Pediatrician Life and Career Experience Study (PLACES), were used to examine self-reported work satisfaction from 2012 to 2020 among 2002-2004 and 2009-2011 residency graduates (N = 1794). Drawing from the Physician Worklife Study, work satisfaction was measured as a 4-item scale score and averaged [range, 1 (low)-5 (high)]. Mixed effects linear regression for longitudinal analysis examined work satisfaction with year as the lone explanatory variable and then with 11 variables that might change over time (time variant) to assess how changes in work might be linked to increased or decreased satisfaction. RESULTS In total, 85.9% of pediatricians in 2020 (September-December) thought their work was personally rewarding. Overall mean work satisfaction scale score displayed a small but significant (P < .001) decrease over time (3.80 in 2012 to 3.69 in 2020). Mixed effects modeling identified several changes associated with increasing work satisfaction over time: increased flexibility in work hours (B = 0.23; 95% confidence interval, 0.20 to 0.25) and personal support from physician colleagues (B = 0.18; 95% confidence interval, 0.15 to 0.21) had the largest associations. Pediatricians reporting increased stress balancing work and personal responsibilities and increased work hours had decreased satisfaction scores. CONCLUSIONS Early- to midcareer pediatricians expressed high levels of work satisfaction, though, satisfaction scale scores decreased slightly over time for the sample overall, including during 2020 (year 1 of the coronavirus disease 2019 pandemic). Pediatricians reporting increases in flexibility with work hours and colleague support showed the strongest increase in work satisfaction.
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Affiliation(s)
| | | | | | - Amy Jost Starmer
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - William L Cull
- Research, American Academy of Pediatrics, Itasca, Illinois
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Kohlfürst DS, Zöggeler T, Karall D, Kerbl R. Workload and job satisfaction among Austrian pediatricians: gender and generational aspects. Wien Klin Wochenschr 2022; 134:516-521. [PMID: 35739286 PMCID: PMC9300563 DOI: 10.1007/s00508-022-02050-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/28/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to evaluate different factors that may contribute to workload and job satisfaction among Austrian pediatricians. METHODS We conducted an online survey with 16 questions and performed statistical analyses. RESULTS Of 375 participating pediatricians, 61% were female, 39% male, 61% clinicians, 21% panel doctors and 12% private doctors. Overall, job satisfaction was moderate (6 ± 2.4 on a positive scale of 0-10). Higher working hours (p = 0.014) and higher patient numbers (p = 0.000) were significantly associated with lower job satisfaction. Lowest satisfaction was described for administrative or other nonmedical work. Lack of time for patient consultation was also correlated with poor satisfaction. Pediatricians older than 65 years reported the highest job satisfaction whereas pediatricians between 55 and 65 years and younger than 36 years showed the lowest scores. Although male pediatricians worked significantly more often more than 40 h per week than females (75% vs. 53%, p = 0.000), female pediatricians were less satisfied about the proportion of administrative (p = 0.015) and other nonmedical work (p = 0.014). CONCLUSION New working models considering less workload, particularly less nonmedical work and intensified collaboration between pediatric clinicians and practitioners are needed to allow more available time per patient, to increase job satisfaction and thus to raise attractivity for pediatric primary care.
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Affiliation(s)
- Daniela S Kohlfürst
- Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
| | - Thomas Zöggeler
- Department of Paediatrics I, Innsbruck Medical University, Innsbruck, Austria
| | - Daniela Karall
- Department of Paediatrics I, Innsbruck Medical University, Innsbruck, Austria
| | - Reinhold Kerbl
- Department of Paediatrics and Adolescent Medicine, General Hospital Hochsteiermark, Leoben, Austria
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Abstract
Early-career physicians face a broad range of challenges unique to their phase of life and career. Beginning in residency, anesthesiologists encounter stressors unique to their work environment, which, when coupled with their personal life demands, places significant burden and creates potential for burnout. In this article, the authors review the literature to explore the contributors of burnout in early-career anesthesiologists, evaluate the relationship between compassionate care and empathic distress, and propose strategies to prevent and treat burnout in this specific subset of anesthesiologists.
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Affiliation(s)
- Leelach Rothschild
- University of Illinois Hospital and Health Sciences System, 1740 West Taylor Street, Suite 3200, Chicago, IL 60612, USA
| | - Ciera Ward
- Christus Mother Frances Hospital, Attn: Dr Ciera Ward w/ Anesthesia, 800 East Dawson Street, Tyler, TX 75701, USA.
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Muntean LM, Nireștean A, Popa CO, Strete EG, Ghiga DV, Sima-Comaniciu A, Lukacs E. The Relationship between Emotional Stability, Psychological Well-Being and Life Satisfaction of Romanian Medical Doctors during COVID-19 Period: A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19. [PMID: 35270629 DOI: 10.3390/ijerph19052937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 02/01/2023]
Abstract
Due to the COVID-19 pandemic, as well as the fast progression of modern society, occupational stress has recently reached alarming levels with consequences for doctors’ psychological well-being. The aim of this study was to analyze the relationship among emotional stability, psychological well-being, and life satisfaction of medical doctors. We conducted a cross-sectional study on 280 medical doctors from Romania between February 2021 and September 2021, in the period between the third and fourth pandemic waves, who were evaluated by the DECAS, ASSET, and Satisfaction with Life scales. Our results showed that emotional stability is negatively correlated with psychological well-being (r = −0.526, p < 0.000) and positively correlated with life satisfaction (r = 0.319, p < 0.0001). Between psychological well-being and life satisfaction, we found a negative correlation (r = −0.046, p < 0.001). This study shows that there is a correlation among emotional stability, psychological well-being, and life satisfaction, which is why it can be considered that Romanian doctors have generated coping mechanisms during the COVID-19 pandemic.
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Abstract
OBJECTIVES This study aims to determine the prevalence of and identify predictors associated with burnout in pediatric emergency medicine (PEM) physicians and to construct a predictive model for burnout in this population to stratify risk. METHODS We conducted a cross-sectional electronic survey study among a random sample of board-certified or board-eligible PEM physicians throughout the United States and Canada. Our primary outcome was burnout assessed using the Maslach Burnout Inventory on 3 subscales: emotional exhaustion, depersonalization, and personal accomplishment. We defined burnout as scoring in the high-degree range on any 1 of the 3 subscales. The Maslach Burnout Inventory was followed by questions on personal demographics and work environment. We compared PEM physicians with and without burnout using multivariable logistic regression. RESULTS We studied a total of 416 PEM board-certified/eligible physicians (61.3% women; mean age, 45.3 ± 8.8 years). Surveys were initiated by 445 of 749 survey recipients (59.4% response rate). Burnout prevalence measured 49.5% (206/416) in the study cohort, with 34.9% (145/416) of participants scoring in the high-degree range for emotional exhaustion, 33.9% (141/416) for depersonalization, and 20% (83/416) for personal accomplishment. A multivariable model identified 6 independent predictors associated with burnout: 1) lack of appreciation from patients, 2) lack of appreciation from supervisors, 3) perception of an unfair clinical work schedule, 4) dissatisfaction with promotion opportunities, 5) feeling that the electronic medical record detracts from patient care, and 6) working in a nonacademic setting (area under the receiver operating characteristic curve, 0.77). A predictive model demonstrated that physicians with 5 or 6 predictors had an 81% probability of having burnout, whereas those with zero predictors had a 28% probability of burnout. CONCLUSIONS Burnout is prevalent in PEM physicians. We identified 6 independent predictors for burnout and constructed a scoring system that stratifies probability of burnout. This predictive model may be used to guide organizational strategies that mitigate burnout and improve physician well-being.
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Affiliation(s)
- Janienne E Kondrich
- From the Division of Pediatric Emergency Medicine, Departments of Emergency Medicine and Pediatrics, NewYork-Presbyterian and Weill Cornell Medicine, Komansky Children's Hospital, New York, NY
| | - Reintine Han
- Department of Family Medicine, Hackensack Meridian Mountainside Medical Center, Verona, NJ
| | - Sunday Clark
- Department of Emergency Medicine, NewYork-Presbyterian and Weill Cornell Medicine, New York, NY
| | - Shari L Platt
- From the Division of Pediatric Emergency Medicine, Departments of Emergency Medicine and Pediatrics, NewYork-Presbyterian and Weill Cornell Medicine, Komansky Children's Hospital, New York, NY
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Wenig AJ, Stonebrook EJ, Bignall ONR. "Reasons … the reasons that we're here:" Young pediatric nephrologists reflect on the profession. Front Pediatr 2022; 10:963811. [PMID: 36389376 PMCID: PMC9643686 DOI: 10.3389/fped.2022.963811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Alexandra J Wenig
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, Oh, United States
| | - Emily J Stonebrook
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, Oh, United States.,Department of Pediatrics, Division of Nephrology and Hypertension, The Ohio State University College of Medicine, Columbus, Oh, United States
| | - O N Ray Bignall
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, Oh, United States.,Department of Pediatrics, Division of Nephrology and Hypertension, The Ohio State University College of Medicine, Columbus, Oh, United States
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Fu MM, Chen RY, Fu MW, Kao HC, Kao HC, Chan HL, Fu E, Lee TSH. Life Satisfaction of US-trained Dental Specialists in Taiwan. Int Dent J 2022; 72:194-202. [PMID: 35065797 PMCID: PMC9275317 DOI: 10.1016/j.identj.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/05/2022] Open
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Miller K, Benny A, Retallack J. Supporting consulting paediatrics in rural, remote, or vulnerable communities in British Columbia: Time for national collaboration. Paediatr Child Health 2021; 26:451-455. [DOI: 10.1093/pch/pxab043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/11/2021] [Indexed: 11/13/2022] Open
Abstract
Abstract
Rural consultant paediatricians in Canada are in short supply. Rural communities across the country could benefit from the implementation of strategies to ensure access to consistent, local consultant paediatric care. Compared to their urban counterparts, rural paediatricians face unique challenges, including significant call requirements, potential risk of burnout and difficulty in recruitment. In response to these challenges, a number of strategies to bolster the provision of paediatric care to rural, remote, and underserved communities have evolved in British Columbia, including virtual support, the development of a rural paediatric network, and new training opportunities. It is time for discussions about the vulnerability of consulting paediatric care in rural or underserved communities to occur at the national level. National engagement will foster collaboration, drive research, and facilitate workforce planning, with the goal of ensuring that all Canadian communities have access to consulting paediatric care.
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Affiliation(s)
- Kirsten Miller
- University Hospital of Northern British Columbia – Paediatrics, Prince George, British Columbia, Canada
- The University of British Columbia Faculty of Medicine – Northern Medical Program, Prince George, British Columbia, Canada
- The University of British Columbia – Pediatrics, Vancouver, British Columbia, Canada
| | - Alexander Benny
- The University of British Columbia Faculty of Medicine – Northern Medical Program, Prince George, British Columbia, Canada
| | - Jennifer Retallack
- The University of British Columbia – Pediatrics, Vancouver, British Columbia, Canada
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Marchalik R, Marchalik D, Wang H, Pasieka H. Drivers and sequelae of burnout in U.S. dermatology trainees. Int J Womens Dermatol 2021; 7:780-786. [PMID: 35028382 PMCID: PMC8714592 DOI: 10.1016/j.ijwd.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/18/2021] [Accepted: 05/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background Burnout is a health care epidemic. Although burnout has been shown to affect dermatologists in multispecialty studies, there are no such studies in dermatology trainees. Objective We conducted a survey-based study of burnout in U.S. dermatology trainees to identify its drivers and sequelae. Methods All residents enrolled in a U.S. dermatology training program were eligible. The 45-question survey included the Maslach Burnout Inventory, a validated quality of life index, and 31 questions based on known drivers of burnout and new research questions. No identifying data were collected. Results A total of 180 residents responded, for a response rate of 14.4%. Notably, an analysis of the cohort showed that our sample was not statistically different from the national complement of trainees based both on proportion of female respondents and mean age (p = .9449 and .2376, respectively). Of the respondents, 59% were female. The average age was 30.6 years. Sixty-nine percent of trainees (124 of 180) met the criteria for burnout. On univariate analysis, age, sex, training year, and relationship status were not associated with burnout. Good work–life balance (p = .032), autonomy in the workplace (p = .0027), intradisciplinary respect (p = .022), and increased work hours (p = .0110) were protective. On multivariate analysis, autonomy in the workplace (odds ratio: 3.580; confidence interval, 1.32–9.71; p = .012) and good work–life balance (odds ratio: 0.262; confidence interval, 0.095–0.722; p = .0097) remained significant. Conclusion Improving control over working environment, as evidenced by the impact of work–life balance and autonomy, may lessen burnout in trainees. Further studies analyzing regional and program-specific variations will help improve trainee experience.
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Abstract
OBJECTIVES To examine the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated workflow changes, such as deployment on pediatric faculty burnout in an early epicenter of the pandemic. We hypothesized burnout would increase during the COVID-19 surge. METHODS We conducted serial cross-sectional surveys of pediatric faculty at an academic, tertiary-care children's hospital that experienced a COVID-19 surge in the Northeastern United States. Surveys were administered pre-surge (February 2020), during the surge (April 2020), and postsurge (September 2020). The primary outcome was burnout prevalence. We also measured areas of worklife scores. We compared responses between all 3 survey periods. Continuous variables were analyzed by using Student's t or Mann-Whitney tests, and categorical variables were analyzed by using χ2 or Fisher's exact test, as appropriate. RESULTS Our response rate was 89 of 223 (40%) presurge, 100 of 267 (37%) during the surge, and 113 of 275 (41%) postsurge. There were no differences in demographics, including sex, race, and academic rank between survey periods. Frequency of burnout was similar in all 3 periods (20% to 26%). The mean scores of emotional exhaustion improved during the surge (2.25 to 1.9; P = .04). CONCLUSIONS Contrary to our hypothesis, we found no changes in pediatric faculty burnout after a COVID-19 surge. Emotional exhaustion improved during the COVID-19 surge. However, these findings represent short-term responses to the COVID-19 surge. Longer-term monitoring of the impact of the COVID-19 surge on pediatric faculty burnout may be necessary for health care organizations to mitigate burnout.
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Affiliation(s)
- Audrey M Uong
- Department of Pediatrics, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
| | - Michael D Cabana
- Department of Pediatrics, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
| | - Janet R Serwint
- Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Carol A Bernstein
- Department of Psychiatry, Albert Einstein College of Medicine, Bronx, New York
| | - Elaine E Schulte
- Department of Pediatrics, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
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Powell WT, Dundon KMW, Frintner MP, Kornfeind K, Haftel HM. Parenthood, Parental Benefits, and Career Goals Among Pediatric Residents: 2008 and 2019. Pediatrics 2021; 148:183447. [PMID: 34814184 DOI: 10.1542/peds.2021-052931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Examine reported availability of parental benefits for pediatric residents and impact of parenthood on reported importance of characteristics of post-training positions and career goals in 2008 and 2019. METHODS We analyzed data from American Academy of Pediatrics surveys of graduating residents in 2008 and 2019 querying (1) parenthood, (2) benefits during residency, (3) importance of parental benefits and job characteristics in post-training position, and (4) subspecialty career goal. Logistic regression was used to estimate independent effects of gender, partner status, and parenthood via derived predicted values (PVs). RESULTS Of 1021 respondents, three-fourths were women. Respondents in 2019 were less likely than in 2008 to have children (24.5% vs 33.8%, P < .01). In 2019, respondents were less likely to report availability of maternity (PV = 78.5% vs 89.5%, P < .001) or parental leave (PV = 42.5% vs 59.2%, P < .001) and more likely to report availability of lactation space (PV = 77.8% vs 56.1%, P < .001.). Most residents reported control over work hours, family considerations, and number of overnight calls per month as essential or very important characteristics in post-training positions. Controlling for resident characteristics, parenthood was associated with importance of family considerations and overnight calls in post-training position. Parenthood did not associate with subspecialty career goals, but gender did. CONCLUSIONS Residents are less likely to report availability of parental benefits during residency training in 2019. Most residents, both those with children and those without, consider parent friendly characteristics important in post-training positions. Parenthood does not correlate with subspecialty career goals independent from gender.
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Affiliation(s)
- Weston T Powell
- Division of Pediatric Pulmonology and Sleep Medicine, Seattle Children's Hospital, Department of Pediatrics, University of Washington, Seattle, Washington
| | - Kelly M W Dundon
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington
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Schwartz LP, Devine JK, Hursh SR, Mosher E, Schumacher S, Boyle L, Davis JE, Smith M, Fitzgibbons SC. Biomathematical Modeling Predicts Fatigue Risk in General Surgery Residents. J Surg Educ 2021; 78:2094-2101. [PMID: 33994335 DOI: 10.1016/j.jsurg.2021.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/08/2021] [Accepted: 04/11/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To assess resident fatigue risk using objective and predicted sleep data in a biomathematical model of fatigue. DESIGN 8-weeks of sleep data and shift schedules from 2019 for 24 surgical residents were assessed with a biomathematical model to predict performance ("effectiveness"). SETTING Greater Washington, DC area hospitals RESULTS: As shift lengths increased, effectiveness scores decreased and the time spent below criterion increased. Additionally, 11.13% of time on shift was below the effectiveness criterion and 42.7% of shifts carried excess sleep debt. Sleep prediction was similar to actual sleep, and both predicted similar performance (p ≤ 0.001). CONCLUSIONS Surgical resident sleep and shift patterns may create fatigue risk. Biomathematical modeling can aid the prediction of resident sleep patterns and performance. This approach provides an important tool to help educators in creating work-schedules that minimize fatigue risk.
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Affiliation(s)
| | | | - Steven R Hursh
- Institutes for Behavior Resources, Baltimore, Maryland; Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | | | - Lisa Boyle
- MedStar Georgetown University Hospital, Washington, DC
| | - Jonathan E Davis
- Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC
| | - Mark Smith
- MedStar Institute for Innovation, Washington, DC
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Lin YK, Lin BYJ, Lin CD, Chen DY. Relationship between medical students' negative perceptions of colleagues' work-life and burn-out during clerkships: a longitudinal observational cohort study. BMJ Open 2021; 11:e049672. [PMID: 34620660 PMCID: PMC8499250 DOI: 10.1136/bmjopen-2021-049672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Because work and educational environments are closely related and can affect each other, this study examined whether medical students' negative perceptions of their colleagues' work-life balance (NWLB) during their clinical rotations would be related to burn-out in clerkships and investigated the effect of students' gender on this relationship. DESIGN A longitudinal, prospective 2-year cohort study conducted between September 2013 and April 2015. SETTING Medical students from a university school of medicine in Taiwan. PARTICIPANTS One voluntary cohort of undergraduate medical students in clerkships was invited to participate. Among 190 medical students recruited in September 2013, a total of 124 students provided written informed consent. Participants were free to decide whether to complete each survey; therefore, varying numbers of responses were obtained during the study period. Those who responded to our survey for more than 6 months were included in our analyses. Overall, 2128 responses from 94 medical students were analysed, with each student providing an average of 23 responses for 2 years. PRIMARY OUTCOME MEASURE Burn-out was measured using the Professional Quality of Life Scale. RESULTS Our study found that a strong NWLB was related to high burn-out levels among medical students during their clerkships (p<0.001). However, the gender of the student had no effect on this relationship (p>0.05). In addition, our study indicated that medical students living with a companion had decreased burn-out levels than did those living alone during their clerkships. CONCLUSIONS The significance of policies promoting employee work-life balance should be emphasised because of the potential for social contagion effects on medical students. Clerkship trainees might be vulnerable to such negative contagion effects during the transition to their early clinical workplace training and may, therefore, require advanced socialisation and mentoring.
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Affiliation(s)
- Yung Kai Lin
- Department of Surgery, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
- Division of Cardiovascular Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Blossom Yen-Ju Lin
- Department of Medical Humanities and Social Sciences, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Der Lin
- Department of Otolaryngology-Head & Neck Surgery, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Der-Yuan Chen
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
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Schwartz JM, Markowitz SD, Yanofsky SD, Tackett S, Berenstain LK, Schwartz LI, Flick R, Heitmiller E, Fiadjoe J, Lee HH, Honkanen A, Malviya S, Cladis FP, Lee JK, Deutsch N. Empowering Women as Leaders in Pediatric Anesthesiology: Methodology, Lessons, and Early Outcomes of a National Initiative. Anesth Analg 2021; 133:1497-1509. [PMID: 34517375 DOI: 10.1213/ane.0000000000005740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Research has shown that women have leadership ability equal to or better than that of their male counterparts, yet proportionally fewer women than men achieve leadership positions and promotion in medicine. The Women's Empowerment and Leadership Initiative (WELI) was founded within the Society for Pediatric Anesthesia (SPA) in 2018 as a multidimensional program to help address the significant career development, leadership, and promotion gender gap between men and women in anesthesiology. Herein, we describe WELI's development and implementation with an early assessment of effectiveness at 2 years. Members received an anonymous, voluntary survey by e-mail to assess whether they believed WELI was beneficial in several broad domains: career development, networking, project implementation and completion, goal setting, mentorship, well-being, and promotion and leadership. The response rate was 60.5% (92 of 152). The majority ranked several aspects of WELI to be very or extremely valuable, including the protégé-advisor dyads, workshops, nomination to join WELI, and virtual facilitated networking. For most members, WELI helped to improve optimism about their professional future. Most also reported that WELI somewhat or absolutely contributed to project improvement or completion, finding new collaborators, and obtaining invitations to be visiting speakers. Among those who applied for promotion or leadership positions, 51% found WELI to be somewhat or absolutely valuable to their application process, and 42% found the same in applying for leadership positions. Qualitative analysis of free-text survey responses identified 5 main themes: (1) feelings of empowerment and confidence, (2) acquisition of new skills in mentoring, coaching, career development, and project implementation, (3) clarification and focus on goal setting, (4) creating meaningful connections through networking, and (5) challenges from coronavirus disease 2019 (COVID-19) and the inability to sustain the advisor-protégé connection. We conclude that after 2 years, the WELI program has successfully supported career development for the majority of protégés and advisors. Continued assessment of whether WELI can meaningfully contribute to attainment of promotion and leadership positions will require study across a longer period. WELI could serve as a programmatic example to support women's career development in other subspecialties.
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Affiliation(s)
- Jamie McElrath Schwartz
- From the Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Scott D Markowitz
- Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado
| | - Samuel D Yanofsky
- Department of Anesthesiology, University of Southern California, Keck School of Medicine, Los Angeles, California
| | - Sean Tackett
- Department of Medicine, Biostatistics, Epidemiology, and Data Management Core, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Laura K Berenstain
- Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Lawrence I Schwartz
- Department of Anesthesiology, Children's Hospital Colorado/University of Colorado, Aurora, Colorado
| | - Randall Flick
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Children's Center, Mayo Clinic, Rochester, Minnesota
| | - Eugenie Heitmiller
- Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - John Fiadjoe
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Helen H Lee
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, Illinois
| | - Anita Honkanen
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford School of Medicine, Stanford, California
| | - Shobha Malviya
- Department of Anesthesiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Franklyn P Cladis
- The Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jennifer K Lee
- From the Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Nina Deutsch
- Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC
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Frintner MP, Kaelber DC, Kirkendall ES, Lourie EM, Somberg CA, Lehmann CU. The Effect of Electronic Health Record Burden on Pediatricians' Work-Life Balance and Career Satisfaction. Appl Clin Inform 2021; 12:697-707. [PMID: 34341980 DOI: 10.1055/s-0041-1732402] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To examine pediatricians' perspectives on administrative tasks including electronic health record (EHR) documentation burden and their effect on work-life balance and life and career satisfaction. METHODS We analyzed 2018 survey data from the American Academy of Pediatrics (AAP) Pediatrician Life and Career Experience Study (PLACES), a longitudinal cohort study of early and midcareer pediatricians. Cohorts graduated from residency between 2002 and 2004 or 2009 and 2011. Participants were randomly selected from an AAP database (included all pediatricians who completed U.S. pediatric residency programs). Four in 10 pediatricians (1,796 out of 4,677) were enrolled in PLACES in 2012 and considered participants in 2018. Data were weighted to adjust for differences between study participants and the overall population of pediatricians. Chi-square and multivariable logistic regression examined the association of EHR burden on work-life balance (three measures) and satisfaction with work, career, and life (three measures). Responses to an open-ended question on experiences with administrative tasks were reviewed. RESULTS A total of 66% of pediatrician participants completed the 2018 surveys (1,192 of 1,796; analytic sample = 1,069). Three-fourths reported EHR documentation as a major or moderate burden. Half reported such burden for billing and insurance and 42.7% for quality and performance measurement. Most pediatricians reported satisfaction with their jobs (86.7%), careers (84.5%), and lives (66.2%). Many reported work-life balance challenges (52.5% reported stress balancing work and personal responsibilities). In multivariable analysis, higher reported EHR burden was associated with lower scores on career and life satisfaction measures and on all three measures of work-life balance. Open-ended responses (n = 467) revealed several themes. Two predominant themes especially supported the quantitative findings-poor EHR functionality and lack of support for administrative burdens. CONCLUSION Most early to midcareer pediatricians experience administrative burdens with EHRs. These experiences are associated with worse work-life balance including more stress in balancing responsibilities and less career and life satisfaction.
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Affiliation(s)
- Mary Pat Frintner
- American Academy of Pediatrics-Research, Itasca, Illinois, United States
| | - David C Kaelber
- The Center for Clinical Informatics Research and Education, The MetroHealth System/Case Western Reserve University, Cleveland, Ohio, United States
| | - Eric S Kirkendall
- Wake Forest Center for Healthcare Innovation, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Eli M Lourie
- Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Chloe A Somberg
- American Academy of Pediatrics-Research, Itasca, Illinois, United States
| | - Christoph U Lehmann
- Clinical Informatics Center, UT Southwestern Medical Center, Dallas, Texas, United States
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Reverberi E, Manzi C, Van Laar C, Meeussen L. The impact of poor work-life balance and unshared home responsibilities on work-gender identity integration. Self and Identity 2021. [DOI: 10.1080/15298868.2021.1914715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | - Loes Meeussen
- University of Leuven, Belgium
- Research Foundation Flanders, Belgium
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Williams K, Eggett D, Patten EV. How work and family caregiving responsibilities interplay and affect registered dietitian nutritionists and their work: A national survey. PLoS One 2021; 16:e0248109. [PMID: 33690670 PMCID: PMC7946290 DOI: 10.1371/journal.pone.0248109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/22/2021] [Indexed: 11/18/2022] Open
Abstract
Healthcare professionals provide paid care at work and potentially have caregiving responsibilities outside of work; work responsibilities in addition to child and/or elder care is considered double- or triple-duty care. Employees may experience conflict and/or enrichment as their work and family responsibilities interface. This study's purpose is to explore the work and family interface of Registered Dietitian Nutritionists (RDNs), determine the prevalence of work-family conflict and enrichment, and identify characteristics associated with higher work-family conflict and enrichment scores. A survey instrument assessing caregiving responsibilities and work-family conflict and enrichment was distributed electronically to 4,900 RDNs throughout the United States. Frequencies, means, correlative relationships, and ANCOVA were calculated using SAS software 9.04. Of 1,233 usable responses, nearly two-thirds of RDNs (65.5%) reported providing either double-duty or triple-duty care. About half of RDNs (47.2%) reported work-family conflict and fewer (14.8%) reported family-work conflict. Additionally, most RDNs (79.4%) reported work-family enrichment and even more (85.2%) reported family-work enrichment. Higher work-family conflict scores had correlative relationships with higher levels of burnout, lower life satisfaction, and higher intent to quit. Higher work-family enrichment scores had correlative relationships with lower burnout, higher job satisfaction, higher career satisfaction, higher life satisfaction, and lower intent to quit. Understanding the unpaid caregiving responsibilities of RDNs and the interface of work/family responsibilities may provide insight into career planning for RDNs and guide managers of RDNs in efforts to amplify the contribution of RDNs.
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Affiliation(s)
- Karla Williams
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, Utah, United States of America
| | - Dennis Eggett
- Department of Statistics, Brigham Young University, Provo, Utah, United States of America
| | - Emily Vaterlaus Patten
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, Utah, United States of America
- * E-mail:
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Héritier-Laffargue C, Takvorian C, Kyheng M, Nguyen S, Dubos F, Martinot A. Modalities and Determinants of Career Paths in Pediatrics: A Survey of Former Pediatric Residents From Lille University Medical Center. Front Pediatr 2021; 9:715269. [PMID: 34881211 PMCID: PMC8645605 DOI: 10.3389/fped.2021.715269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/27/2021] [Indexed: 11/27/2022] Open
Abstract
There is currently a shortage of pediatricians in the Nord-Pas-de-Calais (NPC) area of France. The shortage affects both hospital positions (since many departures are not replaced) and private practice. The objectives of the present study were to (i) describe the career paths of former pediatric residents from Lille University Medical Center, (ii) identify factors associated with leaving NPC and leaving hospital-based practice, and (iii) compare the characteristics associated with the various types of practice. Methods: Pediatric residents having started their residency at Lille University Medical Center between 1993 and 2013 were invited to fill out an online questionnaire. Main outcomes were leaving NPC and leaving hospital practice. The event rate at different times over a 10-year period was determined using the Kaplan-Meier method. Results: The response rate was 92% (284 out of 310 invited respondents): 61% had changed their place or type of practice at least once, 54% had moved to a different city, and 41% had left NPC. Having trained elsewhere than in Lille and the lack of a chief assistant specialist position in NPC were independently associated with leaving NPC. 73% of the respondents were currently in hospital-based practice. Having started residency after 2003, taking a sabbatical during the residency and not training in a subspecialty (other than general pediatrics) were independently associated with leaving hospital-based practice. The stated reasons for leaving hospital-based practice were on-call duties (according to 71% of the respondents), overwork (46%), family reasons (34%), and a poor atmosphere at work (34%). Hospital-based pediatricians were more active in research and teaching. They worked an average of 13 h more per week than the other respondents, and were less satisfied with their choice of professional activity and their work-life balance. Conclusion: Changes in the place or type of practice have become frequent. With the recent resurgence of interest in private practice, leaving hospital is reportedly associated with better working conditions, greater satisfaction, and a better work-life balance.
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Affiliation(s)
| | - Chloé Takvorian
- CHU Lille, Pediatric Emergency Unit and Infectious Diseases, Lille, France
| | - Maeva Kyheng
- CHU Lille, Department of Biostatistics, Lille, France.,Univ. Lille, ULR 2694 METRICS: Evaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - Sylvie Nguyen
- CHU Lille, Department of Pediatric Neurology, Lille, France
| | - François Dubos
- CHU Lille, Pediatric Emergency Unit and Infectious Diseases, Lille, France.,Univ. Lille, ULR 2694 METRICS: Evaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - Alain Martinot
- CHU Lille, Pediatric Emergency Unit and Infectious Diseases, Lille, France.,Univ. Lille, ULR 2694 METRICS: Evaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
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Patten EV, Beckstead E, Jones M, Spruance LA, Hayes D. School Nutrition Professionals' Employee Safety Experiences During the Onset of the COVID-19 Pandemic. J Nutr Educ Behav 2021; 53:2-9. [PMID: 33423752 DOI: 10.1016/j.jneb.2020.10.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the real-time personal/employee safety experiences and perspectives of school nutrition professionals ranging from frontline staff to state leadership across the US as they responded to the initial weeks of the coronavirus pandemic. METHODS A cross-sectional survey was administered electronically March 31-April 20, 2020, to school nutrition staff, managers, directors, and state agency personnel. Descriptive statistics were calculated, and a thematic analysis of an open-ended item was conducted. RESULTS School nutrition professionals (n = 504) from 47 states responded. Most (86.6%) reported that ensuring employee safety was somewhat or much more difficult during the pandemic, and they were unaware of an emergency plan. Themes from open-ended responses regarding employee safety concerns included, exposure and transmission risk, processes, and personal concerns. CONCLUSIONS AND IMPLICATIONS Attention to the safety and concerns of school nutrition employees is vital for continuation of these programs during this pandemic and for future emergency situations.
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Affiliation(s)
- Emily Vaterlaus Patten
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT.
| | - Emma Beckstead
- Department of Public Health, Brigham Young University, Provo, UT
| | - Mckenna Jones
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT
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Marshall AL, Dyrbye LN, Shanafelt TD, Sinsky CA, Satele D, Trockel M, Tutty M, West CP. Disparities in Burnout and Satisfaction With Work-Life Integration in U.S. Physicians by Gender and Practice Setting. Acad Med 2020; 95:1435-1443. [PMID: 32459677 DOI: 10.1097/acm.0000000000003521] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To explore the interaction between practice setting (academic practice [AP], private practice [PP]) and gender in relation to physician burnout and satisfaction with work-life integration (WLI). METHOD In 2017, the authors administered a cross-sectional survey of U.S. physicians and characterized rates of burnout and satisfaction with WLI using previously validated and/or standardized tools. They conducted multivariable logistic regression to determine the interaction between the included variables. RESULTS Of the 3,603 participants in the final analysis, female physicians reported a higher prevalence of burnout than male physicians in both AP (50.7% vs 38.2%, P < .0001) and PP (48.1% vs 40.7%, P = .001). However, the multivariable analysis found no statistically significant gender-based differences in burnout (odds ratio [OR] 0.94, 95% confidence interval [CI] 0.76-1.17, P = .60). Women and men in AP were less likely to report burnout than men in PP (OR 0.70, 95% CI 0.52-0.94, P = .01 and OR 0.69, 95% CI 0.53-0.90, P < .01, respectively); women in PP did not report different burnout rates from men in PP (OR 0.89, 95% CI 0.68-1.16, P = .38). Women in both AP and PP were less likely to be satisfied with WLI than men in PP (OR 0.62, 95% CI 0.47-0.83, P < .01 and OR 0.75, 95% CI 0.58-0.97, P = .03, respectively); men in AP did not report different satisfaction with WLI than men in PP (OR 1.05, 95% CI 0.82-1.33, P = .71). CONCLUSIONS Gender differences in rates of burnout are related to practice setting and other differences in physicians' personal and professional lives. These results highlight the complex relationships among gender, practice setting, and other personal and professional factors in their influence on burnout and satisfaction with WLI.
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Affiliation(s)
- Ariela L Marshall
- A.L. Marshall is associate professor of medicine, Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; ORCID: http://orcid.org/0000-0001-7388-0422
| | - Liselotte N Dyrbye
- L.N. Dyrbye is professor of medicine and medical education, Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Tait D Shanafelt
- T.D. Shanafelt is Jeanie and Stewart Ritchie Professor of Medicine and associate dean, Stanford School of Medicine, Stanford, California
| | - Christine A Sinsky
- C.A. Sinsky is vice president of professional satisfaction, American Medical Association, Chicago, Illinois
| | - Daniel Satele
- D. Satele is a statistician, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Mickey Trockel
- M. Trockel is clinical associate professor, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Michael Tutty
- M. Tutty is group vice president of professional satisfaction and practice sustainability, American Medical Association, Chicago, Illinois
| | - Colin P West
- C.P. West is professor of medicine, medical education, and biostatistics, Division of General Internal Medicine, Department of Internal Medicine, and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-1628-5023
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Abstract
OBJECTIVE This study aimed to determine the rate of physician burnout among maternal-fetal medicine subspecialists and identify associated factors. STUDY DESIGN Noninternational members of the Society for Maternal-Fetal Medicine (SMFM) were surveyed regarding burnout using a validated tool specifically designed for health professionals (Maslach Burnout Inventory-Human Services Survey). Burnout was defined as exceeding established cutoffs for emotional exhaustion or depersonalization. Demographic information and potential contributors associated with the presence of burnout were also examined. RESULTS The survey was sent to 1,220 members and 44.1% of members completed the entire survey. The physician burnout rate was 56.5%. Factors associated with burnout included female gender, being 5 to 20 years in practice, self-perceived burnout, being somewhat or very dissatisfied with career or supervisor and charting for more than 4 hours per day. Factors associated with less burnout were being male, having some protected time for education and regular exercise. Women scored higher on emotional exhaustion and depersonalization and lower personal accomplishment compared with men. CONCLUSION Physician burnout among the SMFM members is higher than has been reported in other specialties. While some of these factors are modifiable, further study into why women have higher rates of burnout needs to be performed.
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Affiliation(s)
- Francine Hughes
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Antonia P Francis
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Langone Health, New York, New York
| | - Anthony C Sciscione
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Christiana Care Health Systems, Newark, Delaware
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Garcia LC, Shanafelt TD, West CP, Sinsky CA, Trockel MT, Nedelec L, Maldonado YA, Tutty M, Dyrbye LN, Fassiotto M. Burnout, Depression, Career Satisfaction, and Work-Life Integration by Physician Race/Ethnicity. JAMA Netw Open 2020; 3:e2012762. [PMID: 32766802 PMCID: PMC7414389 DOI: 10.1001/jamanetworkopen.2020.12762] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Previous research suggests that the prevalence of occupational burnout varies by demographic characteristics, such as sex and age, but the association between physician race/ethnicity and occupational burnout is less well understood. OBJECTIVE To investigate possible differences in occupational burnout, depressive symptoms, career satisfaction, and work-life integration by race/ethnicity in a sample of US physicians. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, data for this secondary analysis of 4424 physicians were originally collected from a cross-sectional survey of US physicians between October 12, 2017, and March 15, 2018. The dates of analysis were March 8, 2019, to May 21, 2020. Multivariable logistic regression, including statistical adjustment for physician demographic and clinical practice characteristics, was performed to examine the association between physician race/ethnicity and occupational burnout, depressive symptoms, career satisfaction, and work-life integration. EXPOSURES Physician demographic and clinical practice characteristics included race/ethnicity, sex, age, clinical specialty, hours worked per week, primary practice setting, and relationship status. MAIN OUTCOMES AND MEASURES Physicians with a high score on the emotional exhaustion or depersonalization subscale of the Maslach Burnout Inventory were classified as having burnout. Depressive symptoms were measured using the Primary Care Evaluation of Mental Disorders instrument. Physicians who marked "strongly agree" or "agree" in response to the survey items "I would choose to become a physician again" and "My work schedule leaves me enough time for my personal/family life" were considered to be satisfied with their career and work-life integration, respectively. RESULTS Data were available for 4424 physicians (mean [SD] age, 52.46 [12.03] years; 61.5% [2722 of 4424] male). Most physicians (78.7% [3480 of 4424]) were non-Hispanic White. Non-Hispanic Asian, Hispanic/Latinx, and non-Hispanic Black physicians comprised 12.3% (542 of 4424), 6.3% (278 of 4424), and 2.8% (124 of 4424) of the sample, respectively. Burnout was observed in 44.7% (1540 of 3447) of non-Hispanic White physicians, 41.7% (225 of 540) of non-Hispanic Asian physicians, 38.5% (47 of 122) of non-Hispanic Black physicians, and 37.4% (104 of 278) of Hispanic/Latinx physicians. The adjusted odds of burnout were lower in non-Hispanic Asian physicians (odds ratio [OR], 0.77; 95% CI, 0.61-0.96), Hispanic/Latinx physicians (OR, 0.63; 95% CI, 0.47-0.86), and non-Hispanic Black physicians (OR, 0.49; 95% CI, 0.30-0.79) compared with non-Hispanic White physicians. Non-Hispanic Black physicians were more likely to report satisfaction with work-life integration compared with non-Hispanic White physicians (OR, 1.69; 95% CI, 1.05-2.73). No differences in depressive symptoms or career satisfaction were observed by race/ethnicity. CONCLUSIONS AND RELEVANCE Physicians in minority racial/ethnic groups were less likely to report burnout compared with non-Hispanic White physicians. Future research is necessary to confirm these results, investigate factors contributing to increased rates of burnout among non-Hispanic White physicians, and assess factors underlying the observed patterns in measures of physician wellness by race/ethnicity.
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Affiliation(s)
- Luis C. Garcia
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California
| | - Tait D. Shanafelt
- Department of Medicine, Stanford University School of Medicine, Stanford, California
- WellMD Center, Stanford University School of Medicine, Stanford, California
| | - Colin P. West
- Department of Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | | | - Mickey T. Trockel
- Department of Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Laurence Nedelec
- WellMD Center, Stanford University School of Medicine, Stanford, California
| | - Yvonne A. Maldonado
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | | | | | - Magali Fassiotto
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California
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Webber S, Babal JC, Shadman KA, Coller RJ, Moreno MA. Exploring Academic Pediatrician Perspectives of Factors Impacting Physician Well-Being. Acad Pediatr 2020; 20:833-839. [PMID: 32097783 DOI: 10.1016/j.acap.2020.02.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/10/2020] [Accepted: 02/16/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Promotion of physician well-being has emerged as a national priority, yet meaningful interventions depend on further understanding the factors that promote and detract from physician well-being. The aim of this study was to better understand the perspectives of academic pediatricians regarding the factors influencing their well-being. METHODS We conducted a qualitative study using grounded theory methodology. In June 2018, we performed facilitated focus groups with academic pediatric faculty at our institution. Focus groups were audio recorded, transcribed, and analyzed using the constant comparative method to identify key themes. RESULTS Fifty-four pediatricians participated in the focus groups. Key themes included 1) pediatricians feel inundated by collective professional and personal pressures, 2) pediatricians feel they have lost control over how time at work is spent, and 3) obscured professional-personal boundaries can cause erosion of personal life. CONCLUSIONS Pediatricians identified 3 key barriers to well-being: collective pressures, including increasing and competing academic and clinical responsibilities; low value tasks that consume their time; and erosion of personal life. This study adds to the growing literature describing physician well-being as strongly influenced by workplace factors, and offers examples of modifiable factors for further investigation.
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Affiliation(s)
- Sarah Webber
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
| | - Jessica C Babal
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Kristin A Shadman
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Ryan J Coller
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Megan A Moreno
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
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LaLonde L, Bruni T, Lancaster B, Maragakis A. The Association Between Burnout and Pediatrician Management of Adolescent Depression. J Prim Care Community Health 2020; 11:2150132720943335. [PMID: 32698644 PMCID: PMC7378704 DOI: 10.1177/2150132720943335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: Given the increased demand for pediatric primary care
providers to manage adolescent depression, the current study examines the
association between burnout and provider comfort and perception of feasibility
managing adolescent depression. Method: Data were collected from 52
pediatricians at a Midwest academic health center. Results: Higher
scores on depersonalization were associated with lower provider-reported comfort
managing adolescent depression. Emotional exhaustion and personal accomplishment
were not associated with provider-reported comfort managing adolescent
depression. None of the burnout domains were associated with the
provider-reported perception of the feasibility managing adolescent depression
in this setting. Limitations and recommendations for future research regarding
the impact of behavioral health training on burnout are discussed.
Conclusions: The interpersonal stress dimension of burnout is
associated with less comfort managing depression. Adding positive systematic
interventions, such as behavioral health trainings that support pediatricians in
the management of behavioral health may have impact on burnout.
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