Prevalence of Burnout in Board Certified Family Physicians ========================================================== * James C. Puffer * H. Clifton Knight * Thomas R. O'Neill * Monee Rassolian * Andrew W. Bazemore * Lars E. Peterson * Elizabeth G. Baxley ## Abstract Physician burnout has become a critical issue in a rapidly changing health care environment and is reported to be increasing. However, little is known about the prevalence of this problem among board-certified family physicians. Using an abbreviated burnout survey, we found a lower prevalence of this problem than has been previously reported. * Burnout * Professional; Physicians * Family; Prevalence; Surveys and Questionnaires Burnout, the physical and mental exhaustion resulting from working in a stressful environment, has been reported in >50% of all physicians and 63% of family physicians, and it seems to be increasing.1 Even when working in highly satisfying environments, as many as 40% of physicians may report symptoms of burnout.2 Given this information, we were interested in determining the prevalence of this problem among board-certified family physicians. We administered the Mini Z burnout survey, an abbreviated survey instrument developed from the Physician Worklife Survey and the Minimizing Error; Maximizing Outcomes (MEMO) clinician survey3⇓–5 to a subset of practicing family physicians applying to take the American Board of Family Medicine (ABFM) 2016 Family Medicine Certification Examination to continue their certification. Burnout was defined as a positive response to any 3 of 5 potential options offered for the following question in the survey: “Using your own definition of ‘burnout,’ please select 1 of the answers below.” This single item has been shown to be a valid measure of burnout when compared with the Maslach Burnout Inventory.6,7 Using data from the ABFM administrative database and responses to the other Mini Z questions, we performed bivariate analyses to determine factors that were significantly associated with burnout as self-reported on the Mini Z instrument. A total of 2099 family physicians were administered the Mini Z, with a response rate of 100%. Burnout was reported by 515 physicians (24.5%); female sex and age were significantly associated with burnout (Figure 1). ![Figure 1.](http://www.jabfm.org/https://www.jabfm.org/content/jabfp/30/2/125/F1.medium.gif) [Figure 1.](http://www.jabfm.org/content/30/2/125/F1) Figure 1. Prevalence of burnout among board-certified family physicians by sex and age. Our data suggest that the prevalence of burnout among board-certified family physicians may be lower than previously reported for family physicians in general,1 with younger family physicians and women being at particular risk. Although this sample represents only a small number of all 89,223 board-certified ABFM diplomates, it is highly representative of those ABFM diplomates who are >5 years out of residency. The data were randomly sampled from diplomates taking the examination in 2016 to continue their certification, and 100% of those surveyed responded. Additional data collection with subsequent administrations of the ABFM Family Medicine Certification Examination will allow these initial findings to be validated and changes over time to be monitored. However, the lower prevalence of burnout identified among this cohort of board-certified family physicians and the higher reported rates among younger and female family physicians are intriguing findings that deserve further investigation. Better understanding of and addressing the correlated characteristics found in these and subsequent data may help improve professional satisfaction and increase the well-being of family physicians. ## Notes * This article was externally peer reviewed. * *Funding:* none. * *Conflict of interest:* JCP, TRO, and LEP are employees of the ABFM. * See Related Commentary on Page [127](http://www.jabfm.org/lookup/volpage/30/127). * To see this article online, please go to: [http://jabfm.org/content/30/2/125.full](http://jabfm.org/content/30/2/125.full). * Received for publication September 16, 2016. * Revision received November 11, 2016. * Accepted for publication November 16, 2016. ## References 1. 1.Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general U.S. working population between 2011 and 2014. Mayo Clin Proc 2015;90:1600–13. 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