Organizational Response to Professionalism Lapses and U.S. Physician Well-being

To evaluate US physicians' perceptions of their organization's response to professionalism lapses and to examine associations with burnout, career regret, and intent to leave (ITL).

Between October 19, 2023, and March 3, 2024, we surveyed US physicians. A random subset received four items assessing perceptions of their organization's response to unprofessional behavior. Responses were summed to generate the Standards, Accountability, Fairness, Reporting Safety (SAFeR) Scale score (range, 4-20; higher scores indicate more favorable view). Participants also rated the appropriateness of consequences for unprofessional behavior, completed the Maslach Burnout Inventory, and responded to items about career regret and ITL.

Of the 3219 physicians invited to complete the professionalism items, 3119 did so. Women held less favorable views of their organization's response to professionalism lapses relative to men. Approximately half (55%) of physicians believed the process to evaluate allegations of unprofessional behavior was just. Less favorable rating on each professionalism lapse items and higher SAFeR Scale score were strongly correlated with occupational burnout, career regret, and ITL. On multivariable analysis, each 1-point increase in SAFER Scale score was associated with an 8% decrease in the odds of burnout (OR [95% CI], 0.92 [0.90-0.94]), 9% decrease in career choice regret (0.91 [0.89-0.94]), and 7% decrease in ITL (0.93 [0.88-0.98], all P < 0.01).

More favorable perceptions of organizational response to professional lapses were independently associated with lower odds of burnout, career regret, and turnover intentions. Interventions to improve organizational response to professionalism lapses may enhance physician well-being and retention.