Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population
Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population
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DOI：
10.1001/archinternmed.2012.3199
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发表时间：
2012-10-08
影响因子：
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通讯作者：
Oreskovich, Michael R.
中科院分区：
文献类型：
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作者：
Shanafelt, Tait D.;Boone, Sonja;Oreskovich, Michael R.
背景：尽管有大量关于医生职业倦怠的数据，但据我们所知，还没有全国性的研究评估美国医生的职业倦怠率，探索不同专业的差异，或者将医生与其他领域的美国工作者进行比较。方法：我们使用美国医学会医师总档案对来自所有专业学科的美国医生进行了一项全国性的职业倦怠研究，并对美国普通人群进行了基于概率的样本比较。使用经过验证的仪器测量职业倦怠。结果：27276名医生中，有7288名(26.7%)完成了调查。当使用Maslach职业倦怠量表进行评估时，45.8%的医生报告至少有一种职业倦怠症状。不同的专业在职业倦怠方面有很大的差异，在护理途径(家庭医学、普通内科和急诊医学)一线的医生中，职业倦怠的发生率最高。与基于概率的3442名美国成年人的样本相比，医生更有可能出现职业倦怠症状(37.9%比27.8%)，对工作与生活平衡不满意(40.2%比23.2%)(P<；.001)。在根据年龄、性别、关系状况和每周工作时间进行调整的混合多变量分析中，完成的最高教育水平也与职业倦怠有关。与高中毕业生相比，拥有MD或DO学位的人发生职业倦怠的风险更高(OR[OR]，1.36；P<；.001)，而具有学士学位(OR，0.80；P=.048)、硕士学位(OR，0.71；P=.01)或非MD或DO学位的专业或博士学位的人发生职业倦怠的风险更低(OR，0.64；P=0.04)。结论：职业倦怠在内科医生中比在其他美国工人中更常见。处于护理获取第一线的专科医生似乎面临着最大的风险。
Background: Despite extensive data about physician burnout, to our knowledge, no national study has evaluated rates of burnout among US physicians, explored differences by specialty, or compared physicians with US workers in other fields.Methods: We conducted a national study of burnout in a large sample of US physicians from all specialty disciplines using the American Medical Association Physician Masterfile and surveyed a probability-based sample of the general US population for comparison. Burnout was measured using validated instruments. Satisfaction with work-life balance was explored.Results: Of 27 276 physicians who received an invitation to participate, 7288 (26.7%) completed surveys. When assessed using the Maslach Burnout Inventory, 45.8% of physicians reported at least 1 symptom of burnout. Substantial differences in burnout were observed by specialty, with the highest rates among physicians at the front line of care access (family medicine, general internal medicine, and emergency medicine). Compared with a probability-based sample of 3442 working US adults, physicians were more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with work-life balance (40.2% vs 23.2%) (P < .001 for both). Highest level of education completed also related to burnout in a pooled multivariate analysis adjusted for age, sex, relationship status, and hours worked per week. Compared with high school graduates, individuals with an MD or DO degree were at increased risk for burnout (odds ratio [OR], 1.36; P < .001), whereas individuals with a bachelor's degree (OR, 0.80; P = .048), master's degree (OR, 0.71; P = .01), or professional or doctoral degree other than an MD or DO degree (OR, 0.64; P = .04) were at lower risk for burnout.Conclusions: Burnout is more common among physicians than among other US workers. Physicians in specialties at the front line of care access seem to be at greatest risk.