Newswise — Anesthesiologists are experiencing unprecedented levels of workplace stress, according to a study assessing burnout levels since early 2020 published today in Anesthesiology, the peer-reviewed journal of the American Society of Anesthesiologists (ASA). The study found that of the anesthesiologists surveyed in November of 2022 67.7% had a high risk for burnout, up 14.4% from March of 2020, and 18.9% had burnout syndrome, up 37% since 2020.
According to the World Health Organization, burnout is an occupational phenomenon resulting from chronic workplace stress that has not been adequately mitigated.
“Burnout in physicians has detrimental effects on the physicians’ health and quality of life, in addition to the potential harmful effects on quality of care and patient safety,” said Amy E. Vinson, M.D., lead author of the study and assistant professor of anesthesiology at Boston Children’s Hospital and Harvard Medical School, Boston. “There is no single, clear solution to burnout in anesthesiology. However, in our study we offer institutions a starting point to aid in the creation of human-centered, sustainable well-being solutions.”
The authors conducted a nationwide survey of ASA members (i.e., US attending anesthesiologists), which was endorsed by the ASA Committee on Physician Well-Being and the ASA Executive Committee before distribution. The survey was emailed to 24,680 ASA members and completed by 2,698 or 10.9%. Researchers used the Maslach Burnout Inventory, widely accepted as the gold-standard for assessing burnout over three domains: emotional exhaustion, depersonalization, and feelings of personal accomplishment. The researchers used the convention of considering a high score on emotional exhaustion and/or depersonalization to signify high risk for burnout. Those identified to have a high score on emotional exhaustion and/or depersonalization, along with a low score of personal accomplishment, were classified as having “burnout syndrome.”
The study found that factors associated with burnout and burnout syndrome included:
- The perception of support in their worklife;
- The presence of a perceived staffing shortages;
- Working more than 40 hours a week;
- The perception of support in their homelife;
- The amount of time since completion of training.
Perceived lack of support at work and staffing shortages were most strongly associated with high risk for burnout, while perceived lack of support at work was the factor most strongly associated with burnout syndrome.
The highest rates of burnout were seen in the east south central geographic region: Alabama, Kentucky, Mississippi, and Tennessee. Among anesthesiology subspecialties, the highest rates for burnout (77%) and burnout syndrome (23%) were seen in critical care intensivists. Also, anesthesiologists who reported as likely or very likely to leave their job in two years had higher rates of risk for burnout (78.5%) and burnout syndrome (24.3%), compared to those unlikely to leave their job.
Almost 70% of respondents agreed that adequate staffing would be helpful to address burnout, as would improved workplace morale or culture (55.9%), increased compensation (53.5%), reduced weekly hours (52.8%), increased schedule flexibility (51.7%) and improved support from leadership (51.3%).
The study cited both the National Academy of Medicine’s recommendation to use human-centered design processes to co-design solutions and interventions to address physician burnout and a step-by-step approach to addressing physician well-being that incorporates human-centered design, quality improvement and implementation science. Additionally, the authors advised that support from leadership at the organizational level is crucial and suggest the use of Maslach and Leiter’s Six Areas of Work Life which includes: workload, control, reward, community, fairness, and values.
The authors recommended that adequate staffing and improved workplace morale can be helpful in addressing and reducing burnout. Additionally, they said empowering anesthesiologists with more autonomy and management over work practices such as “on-call” scheduling and early/late shift requests may prevent or reduce burnout. They also suggest it is imperative that institutions ensure their workers are reasonably valued and equitably compensated, as well as provide transparency and objectivity when making decisions and allocating institutional resources.
“Organizations need to have a clear strategy to protect clinicians from burnout,” said Dr. Vinson. “More well-being programs should be incorporated in policymaking at the organizational level as well.”
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