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Original article| Volume 90, ISSUE 12, P1600-1613, December 2015

Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014



      To evaluate the prevalence of burnout and satisfaction with work-life balance in physicians and US workers in 2014 relative to 2011.

      Patients and Methods

      From August 28, 2014, to October 6, 2014, we surveyed both US physicians and a probability-based sample of the general US population using the methods and measures used in our 2011 study. Burnout was measured using validated metrics, and satisfaction with work-life balance was assessed using standard tools.


      Of the 35,922 physicians who received an invitation to participate, 6880 (19.2%) completed surveys. When assessed using the Maslach Burnout Inventory, 54.4% (n=3680) of the physicians reported at least 1 symptom of burnout in 2014 compared with 45.5% (n=3310) in 2011 (P<.001). Satisfaction with work-life balance also declined in physicians between 2011 and 2014 (48.5% vs 40.9%; P<.001). Substantial differences in rates of burnout and satisfaction with work-life balance were observed by specialty. In contrast to the trends in physicians, minimal changes in burnout or satisfaction with work-life balance were observed between 2011 and 2014 in probability-based samples of working US adults, resulting in an increasing disparity in burnout and satisfaction with work-life balance in physicians relative to the general US working population. After pooled multivariate analysis adjusting for age, sex, relationship status, and hours worked per week, physicians remained at an increased risk of burnout (odds ratio, 1.97; 95% CI, 1.80-2.16; P<.001) and were less likely to be satisfied with work-life balance (odds ratio, 0.68; 95% CI, 0.62-0.75; P<.001).


      Burnout and satisfaction with work-life balance in US physicians worsened from 2011 to 2014. More than half of US physicians are now experiencing professional burnout.

      Abbreviations and Acronyms:

      AMA (American Medical Association), MBI (Maslach Burnout Inventory), PMF (Physician Master File), WLB (work-life balance)
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        • Shanafelt T.D.
        • Boone S.
        • Tan L.
        • et al.
        Burnout and satisfaction with work-life balance among US physicians relative to the general US population.
        Arch Intern Med. 2012; 172: 1377-1385
        • Horowitz C.R.
        • Suchman A.L.
        • Branch Jr., W.T.
        • Frankel R.M.
        What do doctors find meaningful about their work?.
        Ann Intern Med. 2003; 138: 772-775
        • Clever L.H.
        Some things have not changed.
        Ann Intern Med. 2000; 132: 85-89
        • McMurray J.E.
        • Williams E.
        • Schwartz M.D.
        • et al.
        Physician job satisfaction: developing a model using qualitative data. SGIM Career Satisfaction Study Group.
        J Gen Intern Med. 1997; 12: 711-714
        • Brazeau C.M.
        • Shanafelt T.
        • Durning S.J.
        • et al.
        Distress among matriculating medical students relative to the general population.
        Acad Med. 2014; 89: 1520-1525
        • Dyrbye L.N.
        • West C.P.
        • Satele D.
        • et al.
        Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population.
        Acad Med. 2014; 89: 443-451
        • Shanafelt T.D.
        • Balch C.M.
        • Bechamps G.J.
        • et al.
        Burnout and career satisfaction among American surgeons.
        Ann Surg. 2009; 250: 463-471
        • Maslach C.
        • Jackson S.
        • Leiter M.
        Maslach Burnout Inventory Manual.
        3rd ed. Consulting Psychologists Press, Palo Alto, CA1996
        • Dyrbye L.N.
        • Schwartz A.
        • Downing S.M.
        • Szydlo D.W.
        • Sloan J.A.
        • Shanafelt T.D.
        Efficacy of a brief screening tool to identify medical students in distress.
        Acad Med. 2011; 86: 907-914
        • Shanafelt T.D.
        • Boone S.L.
        • Dyrbye L.N.
        • et al.
        The medical marriage: a national survey of the spouses/partners of US physicians.
        Mayo Clin Proc. 2013; 88: 216-225
        • West C.P.
        • Huschka M.M.
        • Novotny P.J.
        • et al.
        Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study.
        JAMA. 2006; 296: 1071-1078
        • Shanafelt T.D.
        • Balch C.M.
        • Bechamps G.
        • et al.
        Burnout and medical errors among American surgeons.
        Ann Surg. 2010; 251: 995-1000
        • West C.P.
        • Tan A.D.
        • Habermann T.M.
        • Sloan J.A.
        • Shanafelt T.D.
        Association of resident fatigue and distress with perceived medical errors.
        JAMA. 2009; 302: 1294-1300
        • Firth-Cozens J.
        • Greenhalgh J.
        Doctors' perceptions of the links between stress and lowered clinical care.
        Soc Sci Med. 1997; 44: 1017-1022
        • Grol R.
        • Mokkink H.
        • Smits A.
        • et al.
        Work satisfaction of general practitioners and the quality of patient care.
        Fam Pract. 1985; 2: 128-135
        • Haas J.S.
        • Cook E.F.
        • Puopolo A.L.
        • Burstin H.R.
        • Cleary P.D.
        • Brennan T.A.
        Is the professional satisfaction of general internists associated with patient satisfaction?.
        J Gen Intern Med. 2000; 15: 122-128
        • Shanafelt T.
        • Sloan J.
        • Satele D.
        • Balch C.
        Why do surgeons consider leaving practice?.
        J Am Coll Surg. 2011; 212: 421-422
        • Shanafelt T.D.
        • Raymond M.
        • Kosty M.
        • et al.
        Satisfaction with work-life balance and the career and retirement plans of US oncologists.
        J Clin Oncol. 2014; 32: 1127-1135
        • Wallace J.E.
        • Lemaire J.B.
        • Ghali W.A.
        Physician wellness: a missing quality indicator.
        Lancet. 2009; 374: 1714-1721
        • Dyrbye L.N.
        • Shanafelt T.D.
        Physician burnout: a potential threat to successful health care reform.
        JAMA. 2011; 305: 2009-2010
        • Dyrbye L.N.
        • Varkey P.
        • Boone S.L.
        • Satele D.V.
        • Sloan J.A.
        • Shanafelt T.D.
        Physician satisfaction and burnout at different career stages.
        Mayo Clin Proc. 2013; 88: 1358-1367
      1. Friedberg MW, Chen PG, Van Busum KR, et al. Factors affecting physician professional satisfaction and their implications for patient care, health systems, and health policy. 2013. Accessed December 31, 2015.

      2. (AAPOR): Aafpor. Standard definitions: final dispositions of case codes and outcome rates for surveys. 2011. Accessed December 3, 2012.

        • Rafferty J.P.
        • Lemkau J.P.
        • Purdy R.R.
        • Rudisill J.R.
        Validity of the Maslach Burnout Inventory for family practice physicians.
        J Clin Psychol. 1986; 42: 488-492
        • Lee R.T.
        • Ashforth B.E.
        A meta-analytic examination of the correlates of the three dimensions of job burnout.
        J Appl Psychol. 1996; 81: 123-133
        • Leiter M.P.
        • Durup J.
        The discriminant validity of burnout and depression: a confirmatory factor analytic study.
        Anxiety Stress Copin. 1994; 7: 357-373
        • Thomas N.K.
        Resident burnout.
        JAMA. 2004; 292: 2880-2889
        • Shanafelt T.D.
        • Bradley K.A.
        • Wipf J.E.
        • Back A.L.
        Burnout and self-reported patient care in an internal medicine residency program.
        Ann Intern Med. 2002; 136: 358-367
        • Rosen I.M.
        • Gimotty P.A.
        • Shea J.A.
        • Bellini L.M.
        Evolution of sleep quantity, sleep deprivation, mood disturbances, empathy, and burnout among interns.
        Acad Med. 2006; 81: 82-85
        • West C.P.
        • Dyrbye L.N.
        • Sloan J.A.
        • Shanafelt T.D.
        Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals.
        J Gen Intern Med. 2009; 24: 1318-1321
        • West C.P.
        • Dyrbye L.N.
        • Satele D.V.
        • Sloan J.A.
        • Shanafelt T.D.
        Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment.
        J Gen Intern Med. 2012; 27: 1445-1452
        • West C.P.
        • Shanafelt T.D.
        • Kolars J.C.
        Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents.
        JAMA. 2011; 306: 952-960
        • Spitzer R.L.
        • Williams J.B.
        • Kroenke K.
        • et al.
        Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study.
        JAMA. 1994; 272: 1749-1756
        • Whooley M.A.
        • Avins A.L.
        • Miranda J.
        • Browner W.S.
        Case-finding instruments for depression: two questions are as good as many.
        J Gen Intern Med. 1997; 12: 439-445
        • Meehan P.J.
        • Lamb J.A.
        • Saltzman L.E.
        • O'Carroll P.W.
        Attempted suicide among young adults: progress toward a meaningful estimate of prevalence.
        Am J Psychiatry. 1992; 149: 41-44
        • Kessler R.C.
        • Borges G.
        • Walters E.E.
        Prevalence of and risk factors for lifetime suicide attempts in the National Comorbidity Survey.
        Arch Gen Psychiatry. 1999; 56: 617-626
        • Kessler R.C.
        • Berglund P.
        • Borges G.
        • Nock M.
        • Wang P.S.
        Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990-1992 to 2001-2003.
        JAMA. 2005; 293: 2487-2495
        • Cooper-Patrick L.
        • Crum R.M.
        • Ford D.E.
        Identifying suicidal ideation in general medical patients.
        JAMA. 1994; 272: 1757-1762
        • Shanafelt T.D.
        • Balch C.M.
        • Dyrbye L.
        • et al.
        Special report: suicidal ideation among American surgeons.
        Arch Surg. 2011; 146: 54-62
      3. Hawkins M. 2012 Review of physician recruiting incentives. 2012. Accessed May 5, 2014.

        • Sinsky C.A.
        • Willard-Grace R.
        • Schutzbank A.M.
        • Sinsky T.A.
        • Margolius D.
        • Bodenheimer T.
        In search of joy in practice: a report of 23 high-functioning primary care practices.
        Ann Fam Med. 2013; 11: 272-278
        • Linzer M.
        • Levine R.
        • Meltzer D.
        • Poplau S.
        • Warde C.
        • West C.P.
        10 bold steps to prevent burnout in general internal medicine.
        J Gen Intern Med. 2014; 29: 18-20
        • Linzer M.
        • Baier Manwell L.
        • Mundt M.
        • et al.
        Organizational climate, stress, and error in primary care: the MEMO study.
        in: Henriksen K. Battles J.B. Marks E.S. Lewin D.I. Advances in Patient Safety: From Research to Implementation (Volume 1: Research Findings). Agency for Healthcare Research and Quality (US), Rockville, MD2005
        • Shanafelt T.D.
        • Gorringe G.
        • Menaker R.
        • et al.
        Impact of organizational leadership on physician burnout and satisfaction.
        Mayo Clin Proc. 2015; 90: 432-440
        • Shanafelt T.D.
        • West C.P.
        • Sloan J.A.
        • et al.
        Career fit and burnout among academic faculty.
        Arch Intern Med. 2009; 169: 990-995
        • West C.P.
        • Dyrbye L.N.
        • Rabatin J.T.
        • et al.
        Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial.
        JAMA Intern Med. 2014; 174: 527-533
        • Shanafelt T.D.
        • Sloan J.A.
        • Habermann T.M.
        The well-being of physicians.
        Am J Med. 2003; 114: 513-519
        • Shanafelt T.D.
        • West C.P.
        • Poland G.A.
        • LaRusso N.F.
        • Menaker R.
        • Bahn R.S.
        Principles to promote physician satisfaction and work-life balance.
        Minn Med. 2008; 91: 41-43
        • Dyrbye L.N.
        • Satele D.
        • Sloan J.
        • Shanafelt T.D.
        Utility of a brief screening tool to identify physicians in distress.
        J Gen Intern Med. 2013; 28: 421-427
        • Shanafelt T.D.
        • Kaups K.L.
        • Nelson H.
        • et al.
        An interactive individualized intervention to promote behavioral change to increase personal well-being in US surgeons.
        Ann Surg. 2014; 259: 82-88
        • Quill T.E.
        • Williamson P.R.
        Healthy approaches to physician stress.
        Arch Intern Med. 1990; 150: 1857-1861
        • Clever L.H.
        A checklist for making good choices in trying—or tranquil—times.
        West J Med. 2001; 174: 41-43
        • Shanafelt T.
        • Chung H.
        • White H.
        • Lyckholm L.J.
        Shaping your career to maximize personal satisfaction in the practice of oncology.
        J Clin Oncol. 2006; 24: 4020-4026
        • Krasner M.S.
        • Epstein R.M.
        • Beckman H.
        • et al.
        Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians.
        JAMA. 2009; 302: 1284-1293
        • Fortney L.
        • Luchterhand C.
        • Zakletskaia L.
        • Zgierska A.
        • Rakel D.
        Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: a pilot study.
        Ann Fam Med. 2013; 11: 412-420
        • Beckman H.B.
        • Wendland M.
        • Mooney C.
        • et al.
        The impact of a program in mindful communication on primary care physicians.
        Acad Med. 2012; 87: 815-819
        • Southwick S.M.
        • Charney D.S.
        Resilience: The Science of Mastering Life's Greatest Challenges.
        Cambridge University Press, Cambridge, UK2012
        • Zwack J.
        • Schweitzer J.
        If every fifth physician is affected by burnout, what about the other four? Resilience strategies of experienced physicians.
        Acad Med. 2013; 88: 382-389
        • Shanafelt T.D.
        • Oreskovich M.R.
        • Dyrbye L.N.
        • et al.
        Avoiding burnout: the personal health habits and wellness practices of US surgeons.
        Ann Surg. 2012; 255: 625-633
        • Allegra C.J.
        • Hall R.
        • Yothers G.
        Prevalence of burnout in the U.S. oncology community: results of a 2003 survey.
        J Oncol Pract. 2005; 1: 140-147
        • Kuerer H.M.
        • Eberlein T.J.
        • Pollock R.E.
        • et al.
        Career satisfaction, practice patterns and burnout among surgical oncologists: report on the quality of life of members of the Society of Surgical Oncology.
        Ann Surg Oncol. 2007; 14: 3043-3053
        • Asch D.A.
        • Jedrziewski M.K.
        • Christakis N.A.
        Response rates to mail surveys published in medical journals.
        J Clin Epidemiol. 1997; 50: 1129-1136
        • Kasprzyk D.
        • Montaño D.E.
        • St Lawrence J.S.
        • Phillips W.R.
        The effects of variations in mode of delivery and monetary incentive on physicians' responses to a mailed survey assessing STD practice patterns.
        Eval Health Prof. 2001; 24: 3-17
        • Kellerman S.E.
        • Herold J.
        Physician response to surveys: a review of the literature.
        Am J Prev Med. 2001; 20: 61-71
        • Puleo E.
        • Zapka J.
        • White M.J.
        • Mouchawar J.
        • Somkin C.
        • Taplin S.
        Caffeine, cajoling, and other strategies to maximize clinician survey response rates.
        Eval Health Prof. 2002; 25: 169-184

      Linked Article

      • Correction
        Mayo Clinic ProceedingsVol. 91Issue 2
        • Preview
          In the Original Article entitled “Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014” published in the December 2015 issue of Mayo Clinic Proceedings (Mayo Clin Proc. 2015;90(12):1600-1613), the term ophthalmology was spelled incorrectly in Figure 1.
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      • Factors Affecting Burnout in Physicians
        Mayo Clinic ProceedingsVol. 91Issue 4
        • Preview
          I appreciated the insightful data presented by Shanafelt et al1 in their article in the December 2015 issue of Mayo Clinic Proceedings, and I share the concerns about burnout rates among physicians in the United States. Although burnout is undoubtedly a multifactorial issue, one wonders about the role of recent federal mandates.
        • Full-Text
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      • Burnout and the Ethos of Medical Practice
        Mayo Clinic ProceedingsVol. 91Issue 4
        • Preview
          The article by Shanafelt et al1 published in the December 2015 issue of Mayo Clinic Proceedings describes the very serious and worsening problem of burnout among American physicians, and the editorial by Ariely and Lanier2 attempts to elucidate the causes, noting asymmetrical awards, loss of autonomy, and cognitive scarcity. I could not agree more on one point that Ariely and Lanier made, that the “micromanaging of physicians' time and decisions” in the name of productivity by their corporate overseers is a major factor in the burnout and that it needs to be addressed.
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