Elsevier

Mayo Clinic Proceedings

Volume 88, Issue 12, December 2013, Pages 1358-1367
Mayo Clinic Proceedings

Original article
Physician Satisfaction and Burnout at Different Career Stages

https://doi.org/10.1016/j.mayocp.2013.07.016Get rights and content

Abstract

Objective

To explore the work lives, professional satisfaction, and burnout of US physicians by career stage and differences across sexes, specialties, and practice setting.

Participants and Methods

We conducted a cross-sectional study that involved a large sample of US physicians from all specialty disciplines in June 2011. The survey included the Maslach Burnout Inventory and items that explored professional life and career satisfaction. Physicians who had been in practice 10 years or less, 11 to 20 years, and 21 years or more were considered to be in early, middle, and late career, respectively.

Results

Early career physicians had the lowest satisfaction with overall career choice (being a physician), the highest frequency of work-home conflicts, and the highest rates of depersonalization (all P<.001). Physicians in middle career worked more hours, took more overnight calls, had the lowest satisfaction with their specialty choice and their work-life balance, and had the highest rates of emotional exhaustion and burnout (all P<.001). Middle career physicians were most likely to plan to leave the practice of medicine for reasons other than retirement in the next 24 months (4.8%, 12.5%, and 5.2% for early, middle, and late career, respectively). The challenges of middle career were observed in both men and women and across specialties and practice types.

Conclusion

Burnout, satisfaction, and other professional challenges for physicians vary by career stage. Middle career appears to be a particularly challenging time for physicians. Efforts to promote career satisfaction, reduce burnout, and facilitate retention need to be expanded beyond early career interventions and may need to be tailored by career stage.

Section snippets

Study Population

As previously described,13 in June 2011 we selected a diverse sample of 89,831 physicians from all specialty disciplines from the American Medical Association Physician Masterfile. These physicians were sent an e-mail inviting them to participate in an anonymous, voluntary study. In accordance with established survey methods,14 the 27,276 physicians who opened at least one invitation e-mail were considered to have received an invitation to participate in the study.

Study Measures

The survey included items that

Results

As previously reported,13 7288 of the 27,276 physicians who received an invitation to participate (26.3% cooperation rate) completed surveys. Participating physicians had similar demographic characteristics as the 814,022 US physicians listed in the Physician Masterfile, although participants were slightly older and further removed from medical school graduation. Early and later responders (a measure of response bias) were statistically similar with respect to age, sex, and specialty.

Of the

Discussion

In this national sample of US physicians, we identified several notable differences in the work lives, burnout, and career satisfaction of physicians by career stage. Physicians early in their career had the lowest career satisfaction, greatest rates of work-home conflicts, more difficulty resolving work-home conflicts in a manner that allowed both work and home responsibilities to be met, and greater DP. The prevalence of these issues decreased among middle career physicians and was lowest

Conclusion

Physicians face different challenges at different stages of their career. Middle career is a particularly challenging career stage characterized by high work effort, a higher prevalence of burnout, and greater career dissatisfaction regardless of sex, practice setting, and specialty. Strategies to improve the work experience of middle career physicians are needed to maintain productivity, minimize turnover, and improve patient care.

References (39)

  • A. Melville

    Job satisfaction in general practice: implications for prescribing

    Soc Sci Med Med Psychol Med Sociol

    (1980)
  • L.S. Linn et al.

    Health status, job satisfaction, job stress, and life satisfaction among academic and clinical faculty

    JAMA

    (1985)
  • A. Katz

    Better outcome means more job satisfaction: pilot project in Winnipeg and Halifax to enhance physician-patient communication

    Can Fam Physician

    (1999)
  • L.S. Linn et al.

    Physician and patient satisfaction as factors related to the organization of internal medicine group practices

    Med Care

    (1985)
  • J.S. Haas et al.

    Is professional satisfaction of general internists associated with patient satisfaction

    J Gen Intern Med

    (2000)
  • M.R. DiMatteo et al.

    Physicians' characteristics influence patients' adherence to medical treatment: results from the Medical Outcomes Study

    Health Psychol

    (1993)
  • E.S. Williams et al.

    Understanding physicians' intentions to withdraw from practice: the role of job satisfaction, job stress, mental and physical health

    Health Care Manage Rev

    (2001)
  • T.D. Shanafelt et al.

    Burnout and career satisfaction among American surgeons

    Ann Surg

    (2009)
  • L.N. Dyrbye et al.

    Physician burnout: a potential threat to successful health care reform

    JAMA

    (2011)
  • D. Mechanic

    Physician discontent: challenges and opportunities

    JAMA

    (2003)
  • J.P. Leigh et al.

    Physician career satisfaction across specialties

    Arch Intern Med

    (2002)
  • Physician Characteristics and Distribution in the U.S

    (2012)
  • T.D. Shanafelt et al.

    Burnout and satisfaction with work-life balance among U.S. physicians relative to the general U.S. population

    Arch Intern Med

    (2012)
  • American Association for Public Opinion Research. Standard definitions. Final disposition of case codes and outcome...
  • C. Maslach et al.

    Maslach Burnout Inventory Manual

    (1996)
  • J.P. Rafferty et al.

    Validity of the Maslach Burnout Inventory for family practice physicians

    J Clin Psychol

    (1986)
  • R.T. Lee et al.

    A meta-analytic examination of the correlates of the three dimensions of job burnout

    J Appl Psychol

    (1996)
  • M. Leiter et al.

    The discriminant validity of burnout and depression: a confirmatory factor analytic study

    Anxiety Stress Coping

    (1994)
  • W. Schaufeli et al.

    On the clinical validity of the Maslach Burnout Inventory and the Burnout Measure

    Psychol Health

    (2001)
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    For editorial comment, see page 1347

    Dr Boone is currently with the Office of the Associate Vice President, Health Affairs, University of Chicago, Chicago, IL.

    Grant Support: Funding for this study was provided by the American Medical Association, Mayo Clinic Department of Medicine Innovation Award, and the Mayo Clinic Department of Medicine Program on Physician Well-being.

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