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Analysis

Physician Burnout Impacts Safety, Professionalism, Patient Satisfaction

By Christopher Cheney  
   September 13, 2018

Among physicians, burnout increases the odds of involvement in patient safety incidents, unprofessionalism, and lower patient satisfaction.

Physician burnout has the potential to put patient care at risk, recent research shows.

The research, which was published in JAMA Internal Medicine, found burnout increased the likelihood of patient safety incidents, care deficiencies linked to low professionalism, and lower patient satisfaction.

The research examined 47 studies involving more than 42,000 physicians. "This meta-analysis provides evidence that physician burnout may jeopardize patient care; reversal of this risk has to be viewed as a fundamental healthcare policy goal across the globe," the researchers wrote.

In the study, patient safety incidents were adverse events such as diagnostic errors. Low professionalism included weak communication with patients and lack of empathy. Patient satisfaction featured patient-reported data.

The researchers found physician burnout has a negative impact on patient safety, professionalism, and patient satisfaction:

  • Overall physician burnout doubled the odds of involvement in patient safety incidents. All three dimensions of physician burnout—emotional exhaustion, depersonalization, and reduced personal accomplishment—were linked to involvement in patient safety incidents.
     
  • Overall physician burnout doubled the odds of low professionalism. Depersonalization was associated with the highest propensity for unprofessionalism with a 3-fold increased risk.
     
  • Overall physician burnout doubled the odds for low patient satisfaction. Depersonalization was linked to a 4.5-fold increased risk.

The researchers also found that physicians early in their career have a higher propensity for unprofessionalism. "The … association of burnout with low professionalism was significantly larger across studies based on residents and early-career physicians, compared with studies based on middle- and late-career physicians," the researchers wrote.

Implications and recommendations
 

The findings of the research have implications for healthcare costs and clinical care improvement.

The researchers found that physician burnout compromises care safety, and earlier research has shown that adverse events cost several billions of dollars annually. "Physician burnout therefore is costly for healthcare organizations and undermines a fundamental societal need for the receipt of safe care," the researchers wrote.

Addressing physician burnout is an opportunity to improve patient safety and the quality of care. "Our findings support the view that existing care quality and patient safety standards are incomplete; a core but neglected contributor is physician wellness," the researchers wrote.

The JAMA Internal Medicine study offers three recommendations to ease physician burnout:

  • Healthcare organizations should score physician depersonalization with other quality measures to drive interventions for improving quality and patient safety
     
  • Reporting for quality of care and patient safety should be standardized across healthcare organizations to boost understanding of physician burnout and its association with patient care deficiencies
     
  • Healthcare organizations should do more to support physicians in the early stages of their careers.

Supporting physicians when they are residents is crucial, the researchers wrote.

"Residents will be responsible for healthcare delivery for over two decades in the future. Investments in their wellness and professional values, which are largely shaped during early-career years, are perhaps the most efficient strategy for building organizational immunity against workforce shortages and patient harm."

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


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