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Association Between Physician Burnout and Identification With Medicine as a Calling

Published:February 08, 2017DOI:https://doi.org/10.1016/j.mayocp.2016.11.012

      Abstract

      Objective

      To evaluate the association between degree of professional burnout and physicians’ sense of calling.

      Participants and Methods

      US physicians across all specialties were surveyed between October 24, 2014, and May 29, 2015. Professional burnout was assessed using a validated single-item measure. Sense of calling, defined as committing one’s life to personally meaningful work that serves a prosocial purpose, was assessed using 6 validated true-false items. Associations between burnout and identification with calling items were assessed using multivariable logistic regressions.

      Results

      A total of 2263 physicians completed surveys (63.1% response rate). Among respondents, 28.5% (n=639) reported experiencing some degree of burnout. Compared with physicians who reported no burnout symptoms, those who were completely burned out had lower odds of finding their work rewarding (odds ratio [OR], 0.05; 95% CI, 0.02-0.10; P<.001), seeing their work as one of the most important things in their lives (OR, 0.38; 95% CI, 0.21-0.69; P<.001), or thinking their work makes the world a better place (OR, 0.38; 95% CI, 0.17-0.85; P=.02). Burnout was also associated with lower odds of enjoying talking about their work to others (OR, 0.23; 95% CI, 0.13-0.41; P<.001), choosing their work life again (OR, 0.11; 95% CI, 0.06-0.20; P<.001), or continuing with their current work even if they were no longer paid if they were financially stable (OR, 0.30; 95% CI, 0.15-0.59; P<.001).

      Conclusion

      Physicians who experience more burnout are less likely to identify with medicine as a calling. Erosion of the sense that medicine is a calling may have adverse consequences for physicians as well as those for whom they care.

      Abbreviation and Acronym:

      OR ( odds ratio)
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      Linked Article

      • Defining Physician Burnout, and Differentiating Between Burnout and Depression—II
        Mayo Clinic ProceedingsVol. 92Issue 9
        • In Brief
          Shanafelt and Noseworthy1 in a recent study are to be commended for continuing to raise awareness of physician job stress, but their reliance on fractions of questions from what they indicate to be “potentially standardized instruments” to categorize burnout is unfortunate. Among these, the popular Maslach Burnout Inventory (MBI)2 is a proprietary test, and its use in the table titled “Candidate Dimensions of Well-being for Organizations to Access” is flawed. Not only are the ‘cutoff’ scores proposed by the developers of the MBI wholly arbitrary and devoid of any clinical referent,2 the inventory's user manual also warns that “neither the coding nor the original numerical scores should be used for diagnostic purposes.”2 Nonetheless, several authors have attempted to take the complexity of physician burnout syndrome down to even single-item measures validated against the MBI3 and/or to comment on qualitative differences that describe a “sense of calling”4 in making physician assessments.
        • Full-Text
        • PDF
      • Physicians in the 21st Century: Between Identification With Medicine as a Calling and Self-Diagnosing Burnout, Depression, and Anxiety
        Mayo Clinic ProceedingsVol. 92Issue 8
        • In Brief
          The father of medicine, William Osler said: “The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. Often the best part of your work will have nothing to do with potions or powders, but with the exercise of an influence of the strong upon the weak, of the righteous upon the wicked, of the wise upon the foolish.”1
        • Full-Text
        • PDF