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Analysis

Resilience is Not the Key to Addressing Physician Burnout, Researchers Find

By Christopher Cheney  
   July 17, 2020

New research suggests organizational approaches to reducing physician burnout such as improving the work environment are more effective than resilience training.

Physicians have a higher level of resilience compared to the general U.S. working population, which has significant implications for addressing physician burnout, a recent research article says.

Earlier research indicates that 44% of physicians nationwide experience burnout symptoms such as emotional exhaustion and depersonalization. Resilience training has been proposed as method to reduce physician burnout.

The recent research article, which was published by JAMA Network Open, is based on data collected from more than 5,000 physicians and more than 5,000 individuals in the general working population.

The Connor-Davidson Resilience Scale was used to measure resilience. The scale ranges from 0 to 8, with higher scores indicating higher levels of resilience. The Maslach Burnout Inventory, which includes measures for emotional exhaustion and depersonalization, was used to measure burnout.

The study generated several key data points.

  • Physicians had higher mean resilience scores compared to the general working population, 6.49 vs. 6.25.
     
  • Physicians who did not show signs of overall burnout had higher mean resilience scores than physicians with burnout, 6.82 vs. 6.13.
     
  • A 1-point increase in resilience score was linked to 36% lower odds of overall burnout, but 29% of physicians with the highest possible resilience score experienced burnout.
     
  • In an analysis of resilience scores by medical specialty, physicians in emergency medicine, neurosurgery, and preventive and occupational medicine posted the highest resilience scores. Physicians in general pediatrics, neurology, and obstetrics and gynecology posted the lowest resiliency scores.

Interpreting the data

The results of the study indicate that physicians as a whole do not have a resilience deficit compared to the general working population—a finding that should help guide the response to physician burnout, the lead author of the research article told HealthLeaders.

"Resilience training should not be the mainstay of responses to prevent burnout and promote well-being. Maintaining resilience is still important, but we need to look more to the work environment for solutions to burnout, as individual limitations are not driving physician distress and focusing on them may even be seen as a form of 'victim-blaming,'" said Colin West, MD, PhD, a general internal medicine physician and consultant in the Department of Internal Medicine at Rochester, Minnesota-based Mayo Clinic.

The study's data—particularly the finding that 29% of physicians with the highest possible resilience score experienced burnout—has significant implications, one of the research article's co-authors told HealthLeaders.

"These findings indicate that a focus on increasing personal resilience is inadequate to address the high rates of burnout in physicians," said Tait Shanafelt, MD, chief wellness officer at Stanford Medicine and professor of medicine at Stanford University in Palo Alto, California.

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


KEY TAKEAWAYS

Nearly half of physicians nationwide are experiencing symptoms of burnout, according to research published in 2019.

New research shows that 29% of physicians with the highest possible level of resilience still experience burnout.

Increasing personal resilience is an inadequate response to the physician burnout crisis, co-authors of the new study told HealthLeaders.

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