Physicians in some ethnic minority groups tend to experience lower rates of burnout. The reasons are more than skin deep.
The prevalence and dangers—to physicians and patients—of professional burnout have been well documented. But understanding all of the factors that contribute to the problem is complex.
A Medscape report raises the question of whether physician ethnicity plays a role.
In more than 14,000 physicians across 30 specialties, according to that report, the highest rates of burnout (slide 9) appear in physicians who self-identify as Chinese (56%) and other Asian (53%). Vietnamese and white/Caucasian ethnic groups tied for third (52%), while the lowest percentages occurred among respondents who defined themselves as Asian Indian (46%), Japanese (47%), and black/African American (48%).
JudyAnn Bigby, MD, a senior fellow with Mathematica Policy Research, offers some insight and analysis of the problem. While Bigby was not involved in the Medscape survey, she has researched the correlations of physician ethnicity, bias, and professional satisfaction extensively over her nearly 30-year career practicing general internal medicine.
For starters, determining the true breadth of the difference in burnout rates among ethnicities is difficult when dealing with small numbers in the categories themselves, notes Bigby.
In the Medscape survey, just 4% of respondents self-identified as Chinese, which makes their 56% burnout rate tough to compare to Caucasians, who represent 69% of respondents. Furthermore, respondents to the survey could choose more than one ethnic classification.
Nonetheless, previous research by Bigby and colleagues identified a similar pattern to the Medscape survey. In their 2004 study published in the Journal of the National Medical Association, Hispanic physicians reported significantly higher job and career satisfaction compared to white physicians, but no significant difference in stress. Meanwhile, Asian or Pacific Islander physicians averaged lower job satisfaction and higher stress.
Takeaways for Leaders
Physician burnout is far from skin deep. Based on a career spent studying such matters, Bigby offers three takeaways for physicians and healthcare leaders:
- Mission matters. "Satisfaction is in some ways related to how well the work you're doing aligns with your mission-driven sense of why you went into medicine," Bigby says.
"Hispanic and African American physicians are much more likely to serve in under-resourced and underserved communities, and so the understanding is that there may be a relationship between their goal of doing that service and the ability to serve those communities."
- Community is crucial. "Having a sense of being part of a community [is] one of the factors that predict[s]" whether physicians are satisfied or experiencing burnout, she says.
Healthcare leaders, therefore, should do more to reward and value the time physicians spend interacting with the community outside of clinical practice. "Especially in this day when there's a lot of attention paid to the impact the community context has on individual health…that's a valuable contribution physicians can make."
- Satisfaction is contagious. "Studies show that when physicians are not satisfied, their patients are less likely to be satisfied," Bigby says. "So there's something about physician satisfaction that spills over to their work—whether it's the appearance of being rushed or frenzied or irritable or something else—but there is a correlation.
So as work is ongoing to make healthcare delivery more patient-centered, it's really important to pay attention to physician satisfaction." In addition to the above points, key ways to reduce the burden on physicians include offloading bureaucratic tasks onto other qualified professionals, she adds.
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Debra Shute is the Senior Physicians Editor for HealthLeaders Media.