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Physician burnout in pediatric critical care medicine
A I Fields1, T T Cuerdon, C O Brasseux
1Department of Critical Care Medicine, Children's National Medical Center, George Washington University School of Medicine, Washington, DC, USA.
Insights
Burnout is prevalent among pediatric intensivists, with 50% at risk or experiencing it. Feeling undervalued and lack of success correlate with burnout, while exercise may help mitigate it.
Area of Science:
- Pediatric Critical Care Medicine
- Occupational Health
- Physician Well-being
Background:
- Burnout is a significant concern in high-stress medical fields.
- Pediatric intensivists face unique challenges in critical care settings.
- Understanding burnout prevalence and contributing factors is crucial for physician support.
Purpose of the Study:
- To determine the prevalence of burnout among pediatric intensivists.
- To identify factors associated with burnout in this specialty.
- To examine burnout across diverse practice environments.
Main Methods:
- A population-based survey utilizing a mailed questionnaire with a validated Burnout Scale.
- Inclusion of demographic data, work-related variables, and stress-reduction strategies.
- Analysis of responses from 389 attending physicians in pediatric critical care.
Main Results:
- The average Burnout Score was 3.1 +/- 0.8, with 36% at risk and 14% burned out.
- Burnout was significantly associated with the perception of work not being valued by others.
- Burned out physicians reported lower feelings of success, professional satisfaction, and less routine exercise.
Conclusions:
- Approximately 50% of pediatric intensivists are at risk or experiencing burnout.
- Work perception and feelings of success/satisfaction are strongly linked to burnout.
- Routine exercise showed an association with lower burnout scores, suggesting a potential protective effect.
Objectives:
To determine the prevalence of, and factors associated with, burnout among pediatric intensivists across a variety of practice settings.
Design:
A population-based survey, using a mailed questionnaire that included a previously validated Burnout Scale.
Setting:
Private and academic pediatric critical care practices.
Participants:
Respondents from among all members of the Pediatric Section of the Society of Critical Care Medicine and all physicians certified in pediatric critical care medicine by the American Board of Pediatrics.
Measurements And Main Results:
The questionnaire consisted of demographic items, variables noted in the literature as being associated with burnout (e.g., the individual's perception of how others valued their work, and the use of preventive measures such as regular exercise to relieve stress), and a validated Burnout Scale. The questionnaire also included questions pertaining to past training, practice of other primary specialties or subspecialties, practice settings, admission responsibilities, actual and preferred practice activities, total work effort, academic activities, and causes of stress at work. The Burnout Scale of Pines and Aronson is a self-diagnosis instrument, consisting of 21 questions using a 7-point frequency scale. The total Burnout Score represents an average of the scores for the individual components. Scores of < or = 3 in our study were classified as "not burned out." Scores of > 3 and < or = 4 were classified as "at risk." Scores of > 4 were classified as "burned out." A total of 883 questionnaires were mailed; 474 (56%) were respondent returns and 35 questionnaires could not be delivered. Primary analyses focused on the 389 respondent attending physicians presently practicing pediatric critical care medicine at the time of the survey. The average Burnout Score of these attending physicians was 3.1 +/- 0.8; 36% were classified as being at risk for burnout, and 14% were classified as burned out. There was no association between burnout status and the following work conditions: having fellows; having protected time for research and publications; frequency of being called at home; frequency of returning to the hospital when called at home; or call schedule. Respondents classified as burned out were significantly more likely than respondents who were classified as not burned out to feel that their work was not valued by others. Burned out respondents were less likely than respondents who were not burned out to give the following description: feeling very successful; feeling that their peers viewed them as very successful; feeling satisfied in their professional life; and routinely exercising or having some other outside interest.
Conclusions:
We found that a high degree of burnout exists in pediatric critical care medicine, with 50% of pediatric intensivists at risk or burned out. Overall, there was no association between Burnout Scores and training, practice specialties, or practice settings, nor was there an association with aspects of practice that are physically taxing. However, perceptions about the value of their work and feelings of success and satisfaction were highly associated with those respondents classified as burned out. Routine exercise (a strategy used by some for stress reduction) was associated with lower Burnout Scores. Further studies are necessary to evaluate the trends that we have reported and to identify causal factors.