Physician Burnout Results From Poor Control Over Specific Aspects of Work

Poor control over specific aspects of work was related to burnout and intentions to reduce clinical effort or leave one’s organization among physicians, according to findings published in Annals of Internal Medicine.

Researchers conducted a cross-sectional study to evaluate the relationship between perceived work control and burnout and career intentions. Physicians in the US who responded to the American Medical Association (AMA) Organizational Biopsy survey between November 2022 and December 2023 were included in the study. Multilevel, mixed-effects, multivariable, logistic regression models were used in statistical analysis.

A total of 2339 physicians (men, 55.5%; White, 68.8%) were included in the analysis, 85.9% of whom worked full time clinically and 35.4% of whom practiced both inpatient and outpatient medicine.

Overall, 61.4% of physicians reported adequate control over the volume of their patient load, 60.6% reported adequate control over the members of their clinical team, 49.0% reported adequate influence over hiring of staff, 74.6% reported adequate influence over setting their clinical schedule, 58.3% reported adequate control over their workload, and 61.3% reported that their organization provided them sufficient authority or autonomy over aspects of work for which they were accountable.

No collinearity was observed among the 6 control items.

The 5 items that were independently associated with burnout included:

• Poor control over volume of patient load: odds ratio (OR), 1.35; 95% CI, 1.04-1.75);
• Who is on my team: OR, 1.66; 95% CI, 1.30-2.12;
• Clinical schedule: OR, 1.32; 95% CI, 1.01-1.74;
• Domains for which I am accountable: OR, 1.26; 95% CI, 1.00-1.59; and,
• Workload: OR, 3.83; 95% CI, 2.99-4.90.

Poor control over volume of patient load (OR, 1.61; 95% CI, 1.21-2.13) and workload (OR, 1.40; 95% CI, 1.07-1.83) were independently related to intent to reduce clinical hours.

Poor influence over hiring of staff (OR, 1.61;95% CI, 1.18-2.19), poor control over aspects of work for which they were accountable (OR, 1.40; 95% CI, 1.05-1.87), and poor control over workload (OR, 1.41; 95% CI, 1.03-1.93) were each linked to intent to leave one’s organization.

Study limitations include the cross-sectional design, possible bias, and limited generalization of results to all US physicians.

“Ensuring adequate control over the clinical work environment should be considered one component of a holistic strategy to reduce burnout and retain physicians,” the researchers concluded.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.