ORLANDO — Approximately half the gastroenterologists in the United States have some level of burnout — including feelings of low personal accomplishment, depersonalization, and emotional exhaustion — according to a nationwide survey.
“Burnout has serious implications on the GI workforce, and strategies and resources are needed to increase success in both a physician’s professional and personal life,” said Carol Burke, MD, from the Cleveland Clinic, during a presidential plenary session here at the World Congress of Gastroenterology 2017.
Burnout is a syndrome “characterized by emotional exhaustion; loss of enthusiasm for the work they’re doing; depersonalization, which can include lack of compassion or treating patients as objects; and a diminished sense of personal accomplishment,” she explained.
Of the 11,080 members of the American College of Gastroenterology invited by email to complete the 60-item survey in 2014 and 2015, 1021 responded, for a response rate of 9.2%. The 754 complete responses were assessed using the validated Maslach Burnout Inventory. High subscale scores for depersonalization or emotional exhaustion indicated burnout.
“In our study, 49% of our gastroenterologists are burned out,” Dr Burke reported. Of these, 17% reported feelings of low personal accomplishment, 21% reported depersonalization, and 45% reported experiencing emotional exhaustion.
This figure aligns very closely with the 50% of gastroenterologists who reported burnout in the Medscape Lifestyle Report 2017: Race and Ethnicity, Bias and Burnout.
Many of the “factors associated with burnout in gastroenterologists have not been previously studied,” Dr Burke added.
Levels of burnout were higher in women, in younger gastroenterologists, and in people who reported dissatisfaction with their partner or spouse relationship.
Table: Factors Significantly Associated With Burnout
| Variable | Burnout Reported (n= 372) | No Burnout Reported (n= 382) | P Value |
|---|---|---|---|
| Female, % | 64 | 36 | <.001 |
| Median age, years | 50 | 54 | <.001 |
| Electronic medical records system not user-friendly, % | 56 | 44 | .002 |
Interestingly, type of employment (full- or part-time), type of practice, location, and compensation type “had no impact on levels of burnout,” Dr Burke reported. “We didn’t find that the nature of the practice had any impact. It really gets down to the individual’s professional and personal work–life balance.”
Respondents with high levels of burnout reported that they spent more hours during the week doing domestic chores or caring for children than those without burnout (8 vs 6 hours; P < .001).
And more gastroenterologists in the high-burnout group than in the no-burnout group reported some or extreme dissatisfaction about their spouse or partner relationship or neutral feelings (64% vs 45%; P <.001).
Respondents with high levels of burnout were also spending more hours doing patient-related tasks at home.
“Respondents with high levels of burnout were also spending more hours doing patient-related tasks at home,” Dr Burke pointed out. Interestingly, people who ate breakfast and lunch at work more than 50% of days “were less likely to report burnout.”
“Nearly 50% of gastroenterologist respondents report burnout, and it appears to be more related to work–life balance than to employment factors,” she said.
“I’m not sure this is unique to gastroenterology,” David Johnson, MD, from the Eastern Virginia Medical School in Norfolk, said in a video posted on a recent Johnson on Gastroenterology Medscape blog. However, “we need to take this as a wake-up call.”
“Some institutions are developing physician-wellness programs and physician-wellness initiatives to promote what we view as a potential real problem, not just for our specialty but for physicians in general,” he added.
Solutions Welcome
The survey indicates that a majority — 60% — would use resources, if available, to promote professional and personal well-being.
Mindfulness, journaling, talking to colleagues about clinical practice, and more time for organizational tasks are among the strategies discussed in the medical literature to reduce the risk for burnout.
Of the respondents, 46% said they were considering early retirement, primarily because of decreases in reimbursement, the need to meet certain practice regulations, and maintenance of certification requirements.
In addition, 64% reported considering leaving their current practice situation in the next 2 years. Of this group, 44% said that they would search for a different practice, 28% said they would retire, and 7% said they would leave medicine altogether.
Among the specialties surveyed for the Medscape Lifestyle Report, gastroenterologists ranked pretty high, with 35% reporting that they are happy at work and 71% reporting that they are happy at home. This places gastroenterologists behind urologists, ophthalmologists, dermatologists, allergy and immunologists, and emergency physicians on rankings of happiness, but ahead of 21 other specialists covered in the report.
Dr Burke has disclosed no relevant financial relationships.
World Congress of Gastroenterology at the ACG 2017: Abstract 8. Presented October 16, 2017.
Follow Medscape Gastroenterology on Twitter @MedscapeGastro and Damian McNamara @MedReporter
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