Sense of Belonging, Burnout, and Work Intentions Among US Physicians

A sense of belonging is a fundamental need that predicts mental, physical, social, economic, and behavioral outcomes. Experiencing a sense of belonging at work may be influenced by organizational culture and whether a person feels supported by teammates. There is little evidence of what proportion of physicians feel a strong sense of belonging and teammate support. There exists a gap in literature showing whether these factors are associated with burnout or work intentions, which leaves health care leaders without a valuable tool to improve professional well-being and workforce retention.

To provide health care leaders with a better understanding of how fostering belonging and teammate support can decrease burnout and potentially prevent costly turnover.

This cross-sectional study used data from a survey administered to physicians by their organization leaders as part of the organization's quality improvement efforts through participation in the American Medical Association Organizational Biopsy program. The survey was administered within health care organizations and health systems across the US with more than 50 physicians. The study population comprised physicians working in US-based health care organizations and health systems. Survey responses were collected between November 7, 2023, and November 12, 2024. Analysis was performed from June to August 2025.

Belonging and teammate support perceptions were measured by asking participants to indicate how much they agree with 2 statements. Burnout was assessed using the single-item Mini Z assessment, and work intentions were indicated by likeliness to reduce clinical hours in the next 12 months or leave practice within the next 2 years. Odds ratios (ORs) and 95% CIs were used.

Of 14 051 physicians, 7315 were male (52.1%), 1978 were Asian (14.1%), 406 were Black or African American (2.9%), 425 were Latinx or Hispanic (3.0%), and 8681 were White (61.8%). Additionally, 4733 (33.7%) had 20 or more posttraining years of clinical practice and 4475 (31.8%) practiced in primary care. A strong sense of belonging was endorsed by 8425 (60.0%) and 11 293 (80.4%) perceived teammate support. Females (odds ratio [OR], 0.91, 95% CI, 0.84-0.98) and physicians with more than 5 years of clinical practice (eg, 6-10 years: OR, 0.76; 95% CI, 0.67-0.85; ≥20 years: OR, 0.87; 95% CI, 0.78-0.96) had lower odds of having strong sense of belonging. A strong sense of belonging was associated with lower odds of burnout (OR, 0.22; 95% CI, 0.21-0.24), lower odds of intent to reduce clinical hours (OR, 0.48; 95% CI, 0.44-0.53), and lower odds of intent to leave the organization (OR, 0.23; 95% CI, 0.21-0.26). Similar patterns were observed for factors associated with teammate support and for the association of teammate support with burnout, intent to reduce hours, and intent to leave the organization.

In this cross-sectional study of physicians in the US, a strong sense of belonging was associated with lower odds of burnout, intent to reduce clinical hours, and intent to leave the organization. These findings suggest that fostering belonging and teammate support can benefit physicians, care teams, patients, and organizations by potentially avoiding physician turnover. Organizations should prioritize belonging and teammate support in their efforts to improve culture, work environment, and physician well-being.