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Do Burned Out Doctors Give Low Quality Care?

October 7, 2022

Written by Clay Smith

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Physician burnout has extensive negative effects, not just on individuals, but on hospital systems and on patient safety and satisfaction.

Why does this matter?
Burnout consists of three parts: emotional exhaustion, depersonalization, and reduced sense of personal accomplishment. It makes individual physicians feel awful, but does it translate into external impacts on the organizations for which they work and the quality of patient care? This is the biggest study ever done on this topic. What did they find?

Burnout hurts providers and patients
This was a massive systematic review and meta-analysis of 170 observational studies about burnout that included 239,246 physicians.

Significant associations with burnout included:

  • Lower job satisfaction
  • Career choice regret
  • High employment turnover
  • Reduced productivity
  • Hampered career development
  • Disturbingly, doubled odds of patient safety incidents
  • Lower professionalism
  • Lower patient satisfaction

Who gets burnout? Note, these associations did not remain after multivariate regression.

  • Hospital based
  • Age 31-50
  • ED or ICU physicians

Other tidbits:

  • The association with patient safety was strongest in burned out physicians 20-30 years old and for emergency physicians. In other words, being a burned out resident or emergency physician (or both!) is particularly dangerous for patients.
  • Poor professionalism was strongly associated with being in residency, especially if hospital-based or emergency medicine.

Burnout isn’t just psychologically bad for individuals, it negatively impacts staffing, safety, quality, and patient satisfaction. Some physicians, especially residents and/or those who are hospital-based or EM, are particularly vulnerable to burnout. Reducing burnout is more than bringing in donuts (…not knocking donuts, of course). We need to make sure physicians are supported with a reasonable workload, a culture of healthy peer-to-peer interactions, and by finding ways each person can uniquely contribute and thrive.

Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ. 2022 Sep 14;378:e070442. doi: 10.1136/bmj-2022-070442.

What are your thoughts?