Factors Associated with Well-being and Burnout Among Japanese Internal Medicine Physicians

Objective Physician burnout threatens healthcare quality, safety, and sustainability. Identifying individual (e.g., lifestyle) and organizational (e.g., work environment, leadership) factors is critical for developing effective interventions. This study aimed to examine the factors associated with burnout among board-certified internists in Japan. Methods A nationwide cross-sectional survey was conducted from November 15 to December 31, 2024, among 3,320 internists on the Japanese Society of Internal Medicine mailing list; 353 responded (10.6%). Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which covers emotional exhaustion, depersonalization, and reduced personal accomplishment. The survey also captured professional, community, and personal factors. Results Among 316 complete responses, 17.1% (n=54) met the criteria for extreme burnout (high-risk thresholds in all domains), and 64.6% (n=204) met high-risk thresholds for emotional exhaustion and/or depersonalization. The risk factors included a high workload (OR 2.16, 95% CI 1.36-3.41), electronic health record burden (OR 1.42, 95% CI 1.11-1.83), and preoccupation with the past or future (OR 2.43, 95% CI 1.84-3.21). Protective factors included in-person social interaction (OR 0.58, 95% CI 0.39-0.87), supportive/respectful leadership from supervisors (OR 0.52, 95% CI 0.38-0.69), and perceived support from senior leadership (OR 0.60, 95% CI 0.47-0.78) and co-workers (OR 0.63, 95% CI 0.49-0.81). Conclusion Workload, psychological stress, and leadership quality strongly influence burnout among Japanese internists. Structural interventions that promote a supportive culture and relational well-being may help mitigate burnout.