Sustained approach to understanding physician burnout through evaluation of an organisational well-being strategy

Identifying and addressing factors that impact physician well-being continues to be a challenge for healthcare organisations. In 2018, a physician well-being strategy was implemented at a large academic and teaching mental health hospital in Canada. This study examines physicians' uptake and experiences with organisational well-being initiatives, and their self-reported burnout and professional fulfilment in 2024.

Physicians (n=123) were surveyed between April and June 2024. Survey questions included the Mini-Z and Stanford Professional Fulfillment Index (PFI) scales; assessments of respondents' participation in and perspectives on the organisation's well-being initiatives and open-ended questions eliciting factors influencing their burnout and well-being. Analyses comprised descriptive statistics, Fisher's exact tests and thematic analysis.

Survey response rate was 43.5%, with burnout rates at 20.7% (Mini-Z) and 23.4% (PFI) and professional fulfilment at 32.1% (PFI). Burnout was associated with job satisfaction and organisational dimensions, such as workload and autonomy, and professional fulfilment was associated with clarity of expectations. 56.9% of respondents participated in at least one initiative. Major factors contributing to physicians' well-being were workplace autonomy and meaningfulness (n=71/95), colleagues and teams (n=58/95) and factors outside of work (n=40/95); whereas the top factors contributing to burnout were workload and resources (n=68/90), electronic medical record-related or information technology-related factors (n=37/90) and patient care (n=36/90).

Burnout and professional fulfilment are closely tied to individual and organisational factors. A responsive, holistic approach can better support institutions in meeting physicians' needs, and we propose a shift towards organisational engagement that centres physicians' experiences.