Burnout in the internist--intensivist

Caring for acutely ill patients imposes significant demands on physicians. The environment and stresses of the ICU may lead to the burnout syndrome. The purpose of this study was to evaluate the prevalence of burnout among internal medicine intensivists and the contributing factors present in ICU practice.

Mailed survey utilizing the Maslach Burnout Inventory (MBI). Increasing burnout has been shown to be associated with low levels on personal achievement and high scores on depersonalization and emotional exhaustion.

Random sample of members of the Internal Medicine Section of the Society of Critical Care Medicine.

248 people responded: 220 (88.7%) males and 28 females. Mean age of all respondents was 41.6 +/- 6.7 years. The majority (58.1%) worked in large hospitals (> 400 beds); 55.6% devoted more than 50% of their time to critical care. The emotional exhaustion subscale of the MBI averaged 22.2 +/- 9.5, with a third of respondents scoring in the high range. The depersonalization score averaged 7.1 +/- 5.1%, with 20.4% of respondents scoring in the high range. Similarly personal achievement subscores were poor, with a mean value of 30.9 +/- 6.4%, with 59% scoring in the low range. High levels of emotional exhaustion were associated with anticipating leaving critical care before retirement.

Burnout as measured by the MBI appears to be common in internal medicine intensivists. High levels of emotional exhaustion and depersonalization are related not only to patient care issues but also to a poor support system.