Prevalence of burnout in private practice radiology leaders

Best Practices: Burnout Is More Than Binary

Burnout among radiologists is increasingly prevalent, with the potential for having a substantial negative impact on physician well-being, delivery of care, and health outcomes. To evaluate this phenomenon using reliable and accurate means, validated quantitative instruments are essential. Variation in measurement can contribute to wide-ranging findings. This article evaluates radiologist burnout rates globally and dimensions of burnout as reported using different validated instruments; it also provides guidance on best practices to characterize burnout. Fifty-seven studies published between 1990 and 2023 were included in a systematic review, and 43 studies were included in a meta-analysis of burnout prevalence using random-effects models. The reported burnout prevalence ranged from 5% to 85%. With the Maslach Burnout Inventory (MBI), burnout prevalence varied significantly depending on the instrument version used. Among MBI subcategories, the pooled prevalence of emotional exhaustion was 54% (95% CI, 45-63%), depersonalization was 52% (95% CI, 41-63%), and low personal accomplishment was 36% (95% CI, 27-47%). Other validated burnout instruments showed less heterogeneous results; studies using the Stanford Professional Fulfillment Index yielded a burnout prevalence of 39% (95% CI, 34-45%), whereas the validated single-item instrument yielded a burnout prevalence of 34% (95% CI, 29-39%). Standardized instruments for assessing prevalence alongside multidimensional profiles capturing experiences may better characterize radiologist burnout, including change occurring over time.

Practical Strategies to Retain Radiologists

Since the great resignation associated with the coronavirus disease 2019 pandemic, radiology practices are now challenged with maintaining adequate radiology staffing requirements to cope with increasing clinical workload requirements. The authors describe practical strategies for radiology practice leaders to retain radiologists in the current challenging job market, while mitigating their burnout.

The Second Mountain: Climbing the Challenges of Midcareer Radiology

A radiologist's career can be divided into the early, middle, and late phases. The midcareer phase is a particularly difficult period and has the highest rate of burnout among radiologists. Often throughout the early phase of a radiologist's career, during residency, fellowship, and while a junior faculty member, there is an abundance of support to help in personal and professional growth, but this support often wanes as radiologists gain seniority. Unfortunately, this often leaves midcareer radiologists feeling forgotten, or "invisible." This lack of support can lead to burnout, decreased job satisfaction, and premature departure from the workforce. The purpose of this review is to bring to light the challenges, such as higher rates of burnout and career stagnation, in addition to the lack of emphasis placed on midcareer mentorship, sponsorship, and career development programs, facing radiologists while climbing the "second mountain" of their career, as well as to provide potential individual and institutional interventions to combat these challenges. In addition, emphasis will be placed on the difficulties experienced by midcareer female radiologists, whose challenges are particularly problematic and to our knowledge have received little attention in the imaging literature to date.

Incidence and factors associated with burnout in radiologists: A systematic review

Rationale and objectives

Burnout among physicians has a prevalence rate exceeding 50%. The radiology department is not immune to the burnout epidemic. Understanding and addressing burnout among radiologists has been a subject of recent interest. Thus, our study aims to systematically review studies reporting the prevalence of burnout in physicians in the radiology department while providing an overview of the factors associated with burnout among radiologists.

Materials and methods

The search was conducted from inception until November 13th, 2022, in PubMed, Embase, Education Resources Information Center, PsycINFO, and psycArticles. Studies reporting the prevalence of burnout or any subdimensions among radiology physicians, including residents, fellows, consultants, and attendings, were included. Data on study characteristics and estimates of burnout syndrome or any of its subdimensions were collected and summarized.

Results

After screening 6379 studies, 23 studies from seven countries were eligible. The number of participants ranged from 26 to 460 (median, 162; interquartile range, 91-264). In all, 18 studies (78.3%) employed a form of the Maslach Burnout Inventory. In comparison, four studies (17.4%) used the Stanford Professional Fulfillment Index, and one study (4.3%) used a single-item measure derived from the Zero Burnout Program survey. Overall burnout prevalence estimates were reported by 14 studies (60.9%) and varied from 33% to 88%. High burnout prevalence estimates were reported by only five studies (21.7%) and ranged from 5% to 62%. Emotional exhaustion and depersonalization prevalence estimates were reported by 16 studies (69.6%) and ranged from 11%-100% and 4%-97%, respectively. Furthermore, 15 studies (65.2%) reported low personal accomplishment prevalence, ranging from 14.7% to 84%. There were at least seven definitions for overall burnout and high burnout among the included studies, and there was high heterogeneity among the cutoff scores used for the burnout subdimensions.

Conclusion

Burnout in radiology is increasing globally, with prevalence estimates reaching 88% and 62% for overall and high burnout, respectively. A myriad of factors has been identified as contributing to the increased prevalence. Our data demonstrated significant variability in burnout prevalence estimates among radiologists and major disparities in burnout criteria, instrument tools, and study quality.

Prevalence of Burnout of Radiologists in Private Practice

PURPOSE

The aim of this study was to evaluate the prevalence and demographic factors associated with both burnout and fulfillment of private practice radiologists within the largest coalition of independent wholly physician-owned diagnostic radiology practices within the United States.

METHODS

The study cohort included practicing radiologists within the largest coalition of wholly radiologist-owned, independently practicing diagnostic radiology groups within the United States. Practicing radiologists within all 31 radiology private practices within the organization were electronically mailed a web link to a confidential institutional review board-approved survey in August and September 2021. The survey included validated questions from the Stanford Professional Fulfillment Index, individual and practice demographics, and self-care. Radiologists were classified as being burned out and professionally fulfilled on the basis of established cutoffs from the Professional Fulfillment Index.

RESULTS

The overall response rate was 20.6% (254 of 1,235). The overall rate of radiologist burnout was 46% (Cronbach's α = 0.92), and professional fulfillment was 26.7% (Cronbach's α = 0.91). The inverse association between professional fulfillment and burnout was highly significant (r = -0.66, P < .0001) on the basis of average scores. Radiologists who took call (evenings, overnight, and weekends) were statistically most likely to be burned out. Older radiologists were less likely to experience burnout. Factors statistically significantly associated with professional fulfillment were eating nutritious meals and exercising at least four times per week. No statistically significant association was seen between either burnout or fulfillment with gender, ethnicity, practice geography, or practice size.

CONCLUSIONS

In the largest coalition of independent wholly physician-owned diagnostic radiology practices across the United States, about one-half of radiologists were burned out, and just over one-quarter were professionally fulfilled. Taking call was significantly associated with radiologist burnout. Self-care habits were associated with professional fulfillment.

Leadership: Causing and Curing Burnout in Radiology

Burnout in US radiology has reached crisis proportions. Leaders play critical roles in both causing and preventing burnout. This article will review the current state of the crisis and how leaders can work to stop causing burnout as well as developing proactive strategies for preventing and mitigating burnout.