Burnout on Board: A Cross-Sectional Survey of Burnout and Safety Among Flight Medical Crews

This study aimed to characterize flight medical clinician burnout and its impact on flight team safety.

A cross-sectional anonymous survey was distributed to flight medical clinicians (May to July 2025) via the Air Medical Physician Association and the Association of Air Medical Services. The survey assessed work-environment safety scenarios and burnout (2-item abbreviated Maslach Burnout Inventory). Safety behaviors were compared across burnout levels using Kruskal-Wallis tests.

A total of 450 completed responses were received. Respondents were predominantly located in the United States (n = 408; 90.7%); half were nurses (n = 226), and one-third were paramedics (n = 150). A total of 98 respondents (22.7%) screened positive for high emotional exhaustion, and 90 (20.9%) screened positive for high depersonalization. Respondents indicating burnout at least once a week indicated increased frequency of unsafe practices, such as deferring to a coworker's decision to accept a flight despite not being comfortable with that decision (mean response, 1.98 vs. 1.63; P = .002), ignoring concerning or deteriorating weather conditions due to a need to get to the next destination (1.62 vs. 1.31; P < .001), accepting flights in any weather due to having a good pilot or crew (2.03 vs. 1.58; P < .001), deviating from employer policies to get a job done (2.19 vs. 1.91; P = .002), and decreased frequency in the use of seatbelts during all phases of flight (4.19 vs. 4.53; P < .001).

Flight medical crew respondents indicated a high degree of burnout, which was associated with work behaviors that conflict with culture of safety practices in health care and aviation.