Burnout, Depression, Anxiety, and Stress Among Family Physicians in Kansas: 18 Months into the COVID-19 Pandemic

Samuel Ofei-Dodoo; Colleen Loo-Gross; Rick Kellerman

doi:10.3122/jabfm.2022.05.220045

Article Figures & Data

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Table 1.

Respondents’ Characteristics

Characteristics	2020 (N = 113)	2021 (N = 133)	P Value
Gender, no. (%)			0.543
Male	53 (46.9)	68 (51.1)
Female	43 (38.1)	51 (38.3)
Prefer to not answer	1 (0.9)	1 (0.8)
Missing^*	16 (14.2)	13 (9.8)
Age	(n = 95)	(n = 118)	0.933
Mean (SD), y	48.4 (11.9)	48.6 (11.7)
Median	49	47
Minimum	28	29
Maximum	70	74
Year in clinical practice	(n = 88)	(n = 116)	0.510
Mean (SD), y	16.7 (11.8)	17.8 (11.0)
Median	17.5	17
Minimum	<1	1
Maximum	44	45
Kansas county the physicians primarily practiced, no. (%)			0.326
Butler	5 (4.4)	7 (5.3)
Saline	6 (5.3)	6 (4.5)
Sedgwick	39 (34.5)	54 (40.6)
All other counties	45 (39.8)	56 (42.1)
Missing^*	18 (15.9)	10 (7.5)

Abbreviation: SD, standard deviation.
↵* The number of participants who completed the survey but did not provide an answer to this specific question.

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Table 2.

Relationship of Patient Volume and Concerns About Some Patients Forgoing Care Compared With Participating Years (2020 and 2021)

	Participation Year
Variable	2020 N (%)	2021 N (%)	χ²	P Value	φ
Current patient volume			54.11	<0.001	0.49
More patients	3 (2.3)	35 (26.3)
Fewer patients	74 (65.5)	26 (19.5)
About the same number of patients	35 (31)	65 (48.9)
Missing	1 (0.9)	7 (5.3)
Total	113 (100)	133 (100)
Concerned that some patients may forgo care?			14.09	<0.001	0.25
Yes	94 (83.2)	95 (71.4)
No	6 (5.3)	31 (23.3)
Missing	13 (11.5)	7 (5.3)
Total	113 (100)	133 (100)

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Table 3.

Respondents’ Burnout, Depression, Anxiety, and Stress in 2021 Compared with 2020^{^a}

Variables	2020 (N = 113)	2021 (N = 133)	P Value
Burnout indices
Manifestations of burnout
Burnout	57 (50.4)	92 (69.2)	<0.01
Emotional exhaustion
Median	4	4	–
Mean (SD)	3.95 (1.69)	3.24 (2.19)	<0.01
High score	53 (46.9)	75 (56.4)	0.136
Moderate score	17 (15.0)	39 (29.3)	<0.01
Low score	31 (27.4)	13 (9.8)	<0.001
Missing^*	12 (10.6)	6 (4.5)	NA
Depersonalization
Median	4	1	<0.001
Mean (SD)	3.25 (2.22)	2.05 (2.25)	<0.001
High score	33 (29.2)	83 (62.4)	<0.001
Moderate score	17 (15.0)	22 (16.5)	0.748
Low score	51 (45.1)	22 (16.5)	<0.001
Missing^*	12 (10.6)	6 (4.5)	NA
Depression
Median	1	1	–
Mean (SD)	2.66 (4.13)	3.06 (3.99)	0.472
Minimum	0	0
Maximum	18	20
Missing^*	15 (13.3)	12 (9.0)	NA
Anxiety
Median	0	0
Mean (SD)	1.06 (1.51)	1.38 (2.51)	0.274
Minimum	0	0
Maximum	7	17
Missing^*	14 (12.4)	11 (8.3)	NA
Stress
Median	6	6	–
Mean (SD)	6.0 (5.44)	7.0 (5.46)	0.193
Minimum	0	0
Maximum	21	21
Missing^*	13 (11.5)	10 (7.5)	NA

Abbreviation: NA, not applicable; SD, standard deviation.
↵a Data are presented as number (percentage) unless otherwise.
↵* The number of participants who completed the survey but did not provide an answer to this specific question.

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Table 4.

Open-Ended Comments Regarding Respondents’ Activities Related to Wellness, Mindfulness, or Mental Well-being (Responses = 191)

Theme	Percentage of Responses	Quotes from Participants
Engage in regular physical activities/exercises	29%	“Lots of exercise.”
		“Continued Routine Exercising.”
		“I Have Continued to exercise: run, bike, lift weights and go the gym when it was safer.”
Practice Meditation and yoga	14%	“Meditation Podcasts in the car on my way to work.”
		“Most Important is I have done different yoga classes and meditation.”
		“Meditation on Christian readings.”
		“Yoga and mindfulness activities.”
Engage in religious activities	12%	“I Attend Mass Every Week and sometimes during the week. I frequent reconciliation as well.”
		“Going to Mass, Reading the Bible, and Prayer.”
		“Quiet Times Reading the Bible.”
Engage Support from family and friends	10%	“I Seek Guidance from friends and family.”
		“Mostly Having Dedicated Time with other physicians experiencing similar things to me. It helps to have great friends.”
		“Increased Reaching out to colleagues and friends to share our trials and tribulations.”
Take Time Away from work	9%	Taking Vacation intentionally - Even a ‘staycation.’"
		“Vacation and extra days off.”
		“Vacations as much as possible.”
Engage in hobbies	6%	"Spending Time on activities I enjoy such as reading, avoiding social media.”
		“Spending More Time Cooking and hanging out with family.”
		“Creative Projects.”
		“Creative Arts/Crafts.”
Attend Counseling Sessions	4%	“Weekly Therapy Sessions.”
Attend Counseling Sessions	4%	“Counseling.”
Other Activities	17%	"Routine Medical Care, Usual Stress Relief Activities,"
		“Attend Zoom Seminar.”
		“Listening to wellness podcasts.”
		“Avoiding Social Media.”
		“Quit my Job.”