Doctor burnout leads to poor patient outcomes

A new global report has claimed that when doctor burnout in hospitals is at extremely serious levels it’s putting patients at risk.

People who feel emotionally exhausted at work for a long period of time and become completely detached from the job are likely feeling the effects of ‘burnout’, which is fairly common phenomenon globally amongst workers today.

Interested in the prevalence of burnout amongst physicians and its effect on patient care, a collaboration of researchers from the UK and Greece reviewed 170 observational studies of 239,246 physicians. Their findings are alarming, suggesting the field of medicine is at a crisis point with burnout reaching epidemic levels across the globe, with potentially disastrous results for their patients.

As defined by the study in the British Medical Journal, physician burnout includes three core dimensions: the direct impact of burnout on the individual, the interpersonal aspects between the individual and their job, and finally, how the individual reflects on themselves within the job.

Direct impacts on physicians experiencing burnout included feelings of overwhelming emotional exhaustion, characterised by feeling “overextended and depleted of emotional and physical resources”, while interpersonal aspects included elements of depersonalisation – cynical attitudes, a lack of motivation and “negative, callous or excessively detached response to aspects of the job.” Finally, self-reflections of physicians experiencing burnout reported feelings associated with personal accomplishment, including “incompetence and inadequate achievement and productivity at work”.

Performing a meta-analysis of the 170 studies, the researchers found, among physicians, burnout was associated with an almost four times decrease in job satisfaction and a three times increased likelihood of both career regret and turnover – defined as thoughts or intentions to leave their job.

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Levels of burnout and low job satisfaction tended to be higher in those working in hospital settings, in physicians aged 31-50 years, and intensive care, while burnout was reported least amongst general practitioners.

What is perhaps more concerning for many is the association of physician burnout with poor patient care outcomes.

The research team examined three main aspects of the impact of physician burnout on the quality of patient care: patient safety incidents, level of professionalism and patient satisfaction ratings.

The number of patient safety incidents doubled with physician burnout, with the greatest association between burnout and safety incidents identified between physicians aged 20-30 years and those working in emergency medicine.

Low levels of professionalism and high levels of patient dissatisfaction – as reported by patients – increased twofold, with the greatest association found between physicians still in training or residency; those working in hospitals; those in emergency medicine; and also physicians working in a low to middle income country.

Associations between burnout and low professionalism was lowest in those aged over 50 years.

This is the first meta-analysis study to examine how burnout affects career engagement of physicians and also which places the findings in the context of patient care outcomes.

The report says it is a resounding call for the establishment of a better understanding of the impacts of physician burnout on health workers, their patients and the field of medicine more generally.

Armed with a better understanding of physician burnout can help equip health departments better for proactively addressing and mitigating burnout amongst physicians, with a specific focus on those working in emergency medicine and those in the early stages of their careers.