Alexander Hodkinson
University of Manchester, UK
Title: Does physician burnout effect career engagement and quality of patient care?
Biography
Biography: Alexander Hodkinson
Abstract
Burnout is increasing among physicians and better understanding of the affects career engagement and quality of patient care has could help to mitigate physician burnout. A systematic review and meta-analysis assessed the association of physician burnout (including emotional exhaustion, depersonalization, and personal accomplishment) with career engagement and quality of patient care. Searches for observational studies up until May 2021. Random-effect models pooled the odds ratio. Career engagement outcomes include career choice regret, career development, job satisfaction, and productivity loss and turnover intention. Qualities of patient care outcomes include low professionalism, patient safety incidents, and patient satisfaction. 170 studies including 239,246 physicians included in the meta-analysis. Overall burnout in physicians was associated with almost four-fold decreases in job satisfaction (odds ratio 3.79, 95%CI 3.24-4.43, k=73 studies, n=146,980 physicians), over three-fold increases in career choice regret (3.49, 2.43-5.00, k=16, n=33,871), and three-fold increases in turnover intention (3.10, 2.30-4.17, k=25, n=32,271). Overall physician burnout was also associated with a two-fold increases in patient safety incidents (2.04, 1.69-2.45, k=35, n=41,059), a two-fold decreases in professionalism (2.33, 1.96-2.70, k=40, n=32,321) and a two-fold decrease in patient satisfaction (2.22, 1.38-3.57, k=8, n=1,002). Heterogeneity was above 75%. The link between burnout and poorer job satisfaction was greatest in hospital settings, and in elderly physicians working in emergency medicine. The link between burnout and patient care outcomes was greatest in younger physicians working in emergency medicine. Our meta-analysis provides compelling evidence that physician burnout is associated with poor function and sustainability of healthcare organizations primarily by contributing to the career disengagement and turnover of physicians and secondarily by reducing the quality of patient care. Healthcare organizations should invest more time and effort in implementing evidence-based strategies to mitigate physician burnout across specialties, and particularly in emergency medicine and for physicians in training or residency.