The prevalence of burnout, risk factors, and job-related stressors in gastroenterologists: A systematic review

Burnout Among US Gastroenterologists and Fellows in Training: Identifying Contributing Factors and Offering Solutions

BACKGROUND

Consequences of physician burnout include medical errors, higher rate of staff turnover, and decreased patient satisfaction. We examined the prevalence of burnout and identified the contributing factors in gastroenterologists and fellows in training.

METHODS

We performed 3 separate surveys through the American College of Gastroenterology. (1) A national survey of practicing gastroenterologists in the United States that measured burnout and contributing factors, (2) a survey of gastroenterology fellows in training to determine self-identified burnout, as well as mitigating and exacerbating factors, and (3) a follow-up survey of fellows during the COVID-19 pandemic.

RESULTS

One thousand and twenty-one persons responded (9.2% response rate) to the first survey, including 756 individuals who completed the Maslach Burnout Inventory survey. Overall, the prevalence of high burnout was 49.3%. Factors associated with high burnout included female sex, younger age, shorter duration in practice, considering the electronic health record non-user-friendly, 2 or more hours of patient-related work at home per day, 8 or more hours of outpatient time per day, 6 or more inpatient consults per day, taking call with procedures 10 or more times per year, and having children at home. With regard to lifestyle factors, taking 20 days or more of vacation time was associated with a lower rate of burnout. The level of burnout for fellows was observed to be high (42.7% in survey 2 and 35.3% in survey 3).

CONCLUSIONS

Burnout is high in gastroenterologists and fellows in training. Specific contributing factors were both systems based and personal and provide insight into changes that can be made to address burnout.

Relationship Between Effort-Reward Imbalance, Over-Commitment and Occupational Burnout in the General Population: A Prospective Cohort Study

Objectives: To prospectively investigate the association between Effort-Reward Imbalance (ERI) and over-commitment and the scores of the burnout dimensions over a 4 years follow-up period considering potential confounders. Methods: Data stemmed from CoLaus|PsyCoLaus, a population-based cohort study including 575 participants (mean age 55 years, 50% men). Participants completed the Maslach Burnout Inventory-General Survey, ERI and over-commitment questionnaires at baseline (T1) and after a 4 years follow-up (T2), and provided demographic, behavioral, psychiatric, personality and social support information through self-reported questionnaires and semi-structured interviews. Serially adjusted linear regression models were used. Results: ERI and over-commitment were not associated longitudinally with any of the burnout dimensions when controlling for confounders. One standard deviation increases in the scores of exhaustion, cynicism and professional efficacy were associated with one standard deviation increase in the scores of the same burnout dimensions longitudinally, and these associations were independent of the effects of ERI and over-commitment. Conclusion: Future studies should re-examine the effect of ERI and over-commitment on workers' burnout, considering the effects of confounders.

Burnout and network centrality as proxies for assessing the human cost of resilient performance

The extra effort of healthcare professionals to provide care is a manifestation of resilient performance (RP), usually going unnoticed due to successful outcomes. However, it is not clear how the human cost of RP can be assessed. This study addresses this gap by investigating the relationships between proxies of RP and its human cost. The proposed approach was tested in a 29-bed intensive care unit (ICU). The centrality of each professional in the advice-seeking social network was considered as the proxy of their contribution to system resilience. A resilience score was calculated for each professional as the product of three network centrality metrics (in-degree, closeness, and betweenness) and two non-network attributes, namely their availability and reliability. Professionals' burnout was the proxy of the human cost of RP, assessed through the Maslach Burnout Inventory, composed of 22 items divided into a triad of emotional exhaustion, depersonalization, and personal accomplishment. Both questionnaires, for social network analysis and burnout, included socio-demographic questions and were answered by 99.0% of the professionals. Results indicated a weak correlation between emotional exhaustion and the resilience score (p = 0.008). This score was also weakly correlated with working overtime (p = 0.005). Overall, findings provided initial evidence that RP as measured in our study matters to burnout, and that the two proxies are exemplars of applying a more general reasoning that might be valid for other proxies.

The leadership challenge of increasing productivity in the workplace without increasing burnout risk

Purpose

This paper aims to examine the critical question of how to increase productivity without also increasing the burnout risk. A systems thinking framework was applied to explore individual perceptions of team dynamics and how they relate to morale, work–life balance (WLB) and hours worked.

Design/methodology/approach

Using an online survey, data from 1,222 Australian workers were analysed using hierarchical multiple regression and principal components analysis (PCA).

Findings

Self-reported productivity was found to be predicted by engagement whereas burnout and morale had minimal impact. Burnout risk was not related to hours worked but was reduced when WLB, quality work and trust is higher. Co-worker effort impacted morale and a factor labelled as team “sense of accomplishment” (SoA) was identified.

Research limitations/implications

The results of this research have limited generalisability to wider populations due to sampling methods, being conducted in the Australian context and respondents coming from a diverse range of occupations. The sample being skewed towards younger age groups and the acknowledged use of single-item measures may also restrict drawing broader conclusions from the results.

Originality/value

A socio-technical systems thinking model to diagnose the link between workplace burnout and productivity is applied. The approach involved understanding the importance of trust and how the connection between people and systems can influence morale.

Burnout and work satisfaction are differentially associated in gastroenterologists in Germany

BACKGROUND

Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16-20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30-40% in the United Kingdom, and 50-55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization.

METHODS

We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians.

RESULTS

An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ 2 (18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed.

CONCLUSIONS

Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.

Burnout and work satisfaction are differentially associated in gastroenterologists in Germany

BACKGROUND

Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16-20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30-40% in the United Kingdom, and 50-55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization.

METHODS

We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians.

RESULTS

An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ 2 (18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed.

CONCLUSIONS

Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.

Burnout and work satisfaction are differentially associated in gastroenterologists in Germany

BACKGROUND

Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16-20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30-40% in the United Kingdom, and 50-55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization.

METHODS

We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians.

RESULTS

An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ 2 (18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed.

CONCLUSIONS

Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.

The impact of the coronavirus disease 2019 pandemic on gastroenterologists in Southeast Asia: A mixed-methods study

BACKGROUND AND AIM

The coronavirus disease 2019 pandemic has impacted gastroenterology practices worldwide; however, its protracted effects within Southeast Asia were unknown. The primary aim of the study was to determine the impact of the pandemic on clinical demands including burnout among gastroenterologists within the region. The secondary aim was to identify risk factors for burnout and determine regional stressors.

METHODS

This was a mixed-methods study. Gastroenterologists were surveyed electronically between September 1 and December 7, 2020, via gastroenterology and endoscopy societies of Brunei, Indonesia, Malaysia, Philippines, Singapore, and Thailand. Quantitative and qualitative data were collected. The 22-item Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to detect burnout. Quantitative data were non-parametric; non-parametric methods were used for statistical comparisons. Logistic regression was used to determine risk factors for burnout. Content analysis method was used to analyze qualitative data. Ethical approval was obtained.

RESULTS

A total of 73.0% reported that they were still significantly affected by the pandemic. Of these, 40.5% reported increased workload and 59.5% decreased workload. Statistically significant differences in weekly working hours, endoscopy, and inpatient volumes were present. No differences were observed in outpatient volumes, likely because of telemedicine. Burnout was common; however, 50.1% of gastroenterologists were unaware of or did not have access to mental health support. This, as well as depression, being a trainee, and public sector work, increased burnout risk significantly.

CONCLUSION

The effects of the pandemic are multifaceted, and burnout is common among Southeast Asian gastroenterologists. Safeguards for mental health are suboptimal, and improvements are urgently needed.

Burnout in gastrenterologists: a national-level analysis

INTRODUCTION

The term burn-out or burnout, means 'burn to exhaustion', this term was first used by Herbert Freundenberg. According to Freundenberg, burnout is a 'state of physical and mental exhaustion conditioned by the individual's professional activity'. That is manifested through a set of signs and symptoms associated with physical and emotional breakdown that result from total energy exhaustion and the lack of resources or forces to 'help' others.

OBJECTIVES

Assess the occurrence of burnout in Portuguese gastroenterologists and understand how certain sociodemographic and professional variables might be associated with burnout manifestations.

MATERIAL AND METHODS

Observational descriptive, prospective and multicenter study, with analyzed data related to a sample of 52 national gastroenterologists, during the time between 5 February 2019 and 13 April 2019. An estimate of the burnout levels was carried out by the Copenhagen Burnout Inventory (CBI) questionnaire validated for the Portuguese population - CBI-PT. Possible interconnection between sociodemographic and socio-professional variables were analyzed.

RESULTS

More than half of the gastroenterologists surveyed did not experience burnout in all subscales of the CBI. On a personal level, there were 13 gastroenterologists with moderate burnout and 11 with high burnout. Regarding the work extent, 18 gastroenterologists with moderate burnout and 7 with high burnout were identified. When considering patient level, it was possible to determine 21 gastroenterologists with moderate burnout and 3 with high burnout. There were no cases of severe burnout. Physicians who developed burnout were significantly younger (p < .001), had less service time (p = .007) and less leisure time (p = .024). Doctors in internship had a higher prevalence of burnout, which might be significantly related to a higher level of professional stress (p = .016). The performance of certain examinations (varicose ligation and endoscopic capsule), working during the weekend and the involvement in medico-legal issues had revealed an association with a higher prevalence of burnout.

DISCUSSION AND CONCLUSION

A higher prevalence of burnout was identified in young gastroenterologists, doctors in the internship, those performing high amounts of techniques (upper gastrointestinal endoscopy and colonoscopy), as well as doctors working during the weekend or involvement in legal-medical issues. Therefore, it is possible to conclude that if these young doctors do not acquire tools that will allow them to deal with this problem, it is expected that this pathology will reach critical levels within gastroenterologists, and consequently have a negative impact on healthcare.

An Evaluation of the Performance of Five Burnout Screening Tools: A Multicentre Study in Anaesthesiology, Intensive Care, and Ancillary Staff

Burnout is an important occupational hazard and early detection is paramount in preventing negative sequelae in physicians, patients, and healthcare systems. Several screening tools have been developed to replace lengthy diagnostic tools for large-scale screening, however, comprehensive head–to–head evaluation for performance and accuracy are lacking. The primary objective of this study was to compare the diagnostic performance of five burnout screening tools, including a novel rapid burnout screening tool (RBST). This was a cross-sectional study involving 493 hospital staff (anaesthesiology and intensive care doctors, nurses, and ancillary staff) at the COVID-19 frontline across four hospitals in Singapore between December 2020 and April 2021. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used as the reference standard. Five burnout screening tools, the single-item MBI measure of burnout (SI-MBI), dual-item MBI (DI-MBI), abbreviated MBI (aMBI), Single Item Burnout Question (SIBOQ), and the RBST, were administered via a 36-item online survey. Tools were administered simultaneously and responses were anonymised. Burnout prevalence was 19.9%. The RBST and the SI-MBI had the two highest accuracies (87.8% and 81.9% respectively) and AUROC scores (0.86, 95% CI: 0.83–0.89 and 0.86, 95% CI: 0.82–0.89 respectively). However, the accuracy of the RBST was significantly higher than the SI-MBI (p < 0.0001), and it had the highest positive likelihood ratio (+LR = 7.59, 95% CI 5.65–10.21). Brief screening tools detect burnout albeit with a wide range of accuracy. This can strain support services and resources. The RBST is a free screening tool that can detect burnout with a high degree of accuracy.