Moral Distress and Occupational Burnout in US Physicians

Area of Science:

• Medical Ethics
• Occupational Health
• Physician Well-being

Background:

• Moral distress is a significant concern in healthcare, potentially impacting clinician well-being and retention.
• Exploring the relationship between moral distress and occupational burnout is essential for understanding these interconnected phenomena.

Purpose of the Study:

• To evaluate moral distress among physicians and US workers.
• To investigate the association between moral distress and burnout, intent to leave (ITL), and intent to reduce clinical work hours (ITR).

Main Methods:

• A cross-sectional national survey was conducted with 5741 physicians and 3501 nonphysician US workers.
• Data were collected using the Moral Distress Thermometer (MDT), Maslach Burnout Inventory (MBI), and measures for ITL and ITR.
• Multivariable analysis was employed to explore associations between moral distress and other outcomes.

Main Results:

• Physicians reported higher rates of moral distress compared to other US workers (OR, 4.40).
• High moral distress (score ≥4) was reported by 39.1% of physicians and was significantly associated with increased burnout (75.1% vs 30.7%) and intent to leave.
• Women physicians and those in emergency medicine and general internal medicine specialties showed higher odds of experiencing moral distress.

Conclusions:

• Moral distress is common among physicians and occurs at higher rates than in the general US working population.
• A strong positive correlation exists between moral distress and burnout, intent to leave, and intent to reduce work hours.
• Organizations should focus on understanding the distinctions between moral distress and burnout to implement effective interventions for clinician support.