UMEM Educational Pearls

Category: Quality Assurance/Quality Improvement

Title: Do burned out physicians provide lower quality care?

Keywords: Physician Burnout, Quality of Care, Professionalism (PubMed Search)

Posted: 6/13/2023 by Brent King, MD (Emailed: 8/6/2023) (Updated: 6/19/2023)
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Takeaways: Physicians who have symptoms of burnout as measured by standard burnout scales are more likely to be involved in patient safety incidents, more likely to be cited for poor professionalism, and more likely to have lower patient satisfaction scores. They are also more likely to leave their jobs, experience career regret, and experience job dissatisfaction/ The risk of burnout is highest among emergency physicians and intensivists. 

In this systematic review and meta analysis, the authors reviewed 170 qualitative and quantitative studies including 239,246 physicans to determine the impact of physician burnout on a variety of issues including, quality of care delivered, perception of professionalism, patient satisfaction, and career engagement.

As compared to physicians who did not report symptoms of burnout, burned-out physicians were about four times more likely to be unhappy in their jobs and three times more likely to regret their career decision and to express an intention to leave their jobs.Physician burnout doubled the likelihood of involvement in a patient safety incident and made it three times more likely that the physician would be cited for unprofessional behavior. Burned out physicians were also three times more likely to have low patient satisfaction scores.

Burned-out physicians in their 20's and 30's were particularly at risk for involvement in patient safety incidents and burned-out trainees were more often cited for poor professionalism than older physicians, especially those in their 50's and beyond.

The bottom line: Physican burnout is a serious and growing problem. It has numerous potentially serious consequences for both physicians and patients. Physicians working in high-pressure specialties like emergency medicine and critical care have the highest risk for burnout. 

References

Hodkinson A, Zhou A, Johnson J, et al. Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ 2022;378:e070442. (http://dx.doi.org/10.1136/bmj-2022-070442)