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Physician Burnout and Medicine as a Calling

Patient assignment software can improve care.

Could physician satisfaction and burnout be tied to whether or not that person sees medicine as a calling?

That was the question researchers wanted to answer – the degree to which seeing medicine as a calling is a bellwether of a physician’s mental state as it relates to the job.

Physician burnout is clearly a hot topic in healthcare today. Not only do surveys indicate that it’s affecting more physicians than ever before, but it’s also causing some physicians to leave the profession altogether. And the problem is not isolated to a few specialties. For example, emergency room physicians continue to report the highest level of burnout among their peers (60%), but rheumatology has also seen a big jump in burnout as well. While approximately one-third of rheumatologists reported burnout in 2013, that number jumped to more than one-half in 2017.

Physician burnout has been attributed to a number of different causes — chief among them (at least reported by the physicians themselves) the added burden of having too many bureaucratic tasks. Other factors that lead to burnout: spending too many hours at work, increasing computerization, income that is not high enough, and the feeling that physicians are just a “cog in the wheel.”

Researchers at the Mayo Clinic wanted to look at a different cause – the physicians’ sense of calling.

MEDICINE AS A CALLING

Medicine as a calling has a long history and has been an important element for both physicians and patients. For individual physicians, those who identify with medicine as a calling are typically more engaged in their work and experience less turnover. From a societal standpoint, the general public benefits from having physicians who are motivated to do work that goes beyond their own self-interests. In fact, trust in medicine has been built on this sense of altruism.

But over the past decade or more, concerns have grown that the changing face of the healthcare landscape is eroding the professional identify often associated with medicine as a calling. With a growing frustration of physicians about how their time is being spent in their profession, it’s no wonder physician burnout has been increasing. This raises the question – is there an association between physician burnout and a medicine-as-a-calling attitude.

To answer this question, researchers associated with the Mayo Clinic survey a canvassed a large group of U.S. physicians in 2014 and received completed responses from 2,263 (63% response rate). Among those respondents, nearly 29% of them self-identified themselves as having burnout syndromes. They also had physicians self-report their attitude towards medicine as a calling. Some of the six true/false questions used were:

  • I find my work rewarding.
  • My work is one of the most important things in my life.
  • My work makes the world a better place.
  • I enjoy talking about my work to others.
  • I would choose my current work life again if I had the opportunity.
  • If I were financially secure, I would continue with my current line of work even I were no longer paid.

THE ASSOCIATION BETWEEN BURNOUT AND A SENSE OF CALLING

Multivariable logistic regression associated with the results showed a significant association between the degree of professional burnout and each of the 6 calling items the researchers used. For example, compared with experiencing no burnout – experiencing at least one symptom of burnout was associated with lower odds of identifying with each of the 6 calling items. Physicians who were completely burned out had even lower odds of identification with those characteristics associated with medicine as a calling.

The type of specialty the physician was associated with had no bearing on the results, with the exception of pediatricians – who had higher odds of reporting that they would continue with their work if they were not paid for it. Also, those in medical school setting had higher odds of seeing their work as one of the most important things in their life.

The bottom line according to the researchers – physicians who experienced greater professional burnout were less likely to see medicine as a calling. One potential consequence of this association, according to the researchers, is that physicians who are burnt out may be less intrinsically and socially motivated because they see medicine more as a job and less as a calling—a way to simply earn a paycheck. The researchers concluded that payers, policymakers and physician leaders should “take care to foster a workplace environment that promotes physician well-being and should implement performance-based incentives that support this sense of calling.

Mayo Clin Proc. 2017 Mar;92(3):415-422. doi: 10.1016/j.mayocp.2016.11.012. Epub 2017 Feb 8. Association Between Physician Burnout and Identification With Medicine as a Calling. Jager AJ, Tutty MA, Kao AC

To learn about how our patient assignment software — ASSIGN for Physicians — might help with physician burnout, click here