Study Suggests High Level of Physician Burnout Associated with Discrimination

Sarasota, FL (WorkersCompensation.com) – Job burnout has been a hot topic in the workplace the last couple of years with all of the challenges that workers have faced during the pandemic. Workers who are burnout can impact the financial bottom line as they are 2.6 time more likely to seek another job, 63 percent more likely to take a sick day, and 23 percent more likely to go to the ER. Additionally, burnout doesn’t only effect the employee, but their coworkers as well, multiplying the effect in the process.

When it comes to healthcare, physician productivity, patient access, and increased costs are directly impacted by physician burnout. Physician burnout can have far reaching effects, resulting in lower patient quality of care, which also has an effect on outcomes and patient satisfaction. Burnout can also contribute to an increase in medical errors that result in legal issues. Some studies show that physician burnout is associated with double the risk of medical errors, and a 17 percent increased odds of being named in a medical malpractice suit.

According to statistics from the AMA last summer, around half of healthcare workers reported burnout. Another survey from the Kaiser Family Foundation indicated that 55 percent of front line healthcare workers reported job burnout, with the biggest impact seen among female workers.

Researchers from Mayo Clinic and Stanford School of Medicine asked the question of how frequently do physicians experience mistreatment and discrimination by patients and their families, how does it vary by physician characteristics, and what is the association between the discriminatory interactions and burnout?

The researchers did a cross-sectional survey from November 2020 to March 2021 of 6,512 U.S. physicians across different specialties. Physicians were asked about their experiences at work with patients, and their family members or visitors. Burnout was assessed using the Maslach Burnout Inventory (MBI) under license from Mind Garden, INC. Those physicians with emotional exhaustion scores of 27 or higher, and/or  high depersonalization scores greater than 10 were considered to have symptoms of burnout.

The researchers found that female physicians were more likely to report mistreatment and discrimination. Overall, 29.4 percent of all participants reported they had experienced racially offensive remarks within the last year from patients or their families and visitors. Of those, thirty-four percent of females compared to only 26 percent of males reported being subjected to racially or ethnically offensive remarks. Ethnic minority physicians also saw a greater incident of mistreatment. More than half at 55.8 percent of non-Hispanic Black physicians, 55.4 percent of non-Hispanic Asian, Native Hawaiian, or Pacific Islander physicians, and 52.5 percent of non-Hispanic Indigenous or other physicians had experienced racial remarks in the course of care. By comparison, only 22 percent of white physicians reported racial incidents. When broken out by ethnicity, more female physicians than males reported such experiences.

Over 27 percent of women, and 17.9 percent of males had reported that a patient or family member had refused care due to the physician’s personal attributes.

Overall, 28.7 percent of physicians reported sexist remarks or unwanted sexual advances while working with patients. Of those, 51 percent of the women reported being subjected to offensive sexist remarks, compared to only 15.1 percent of the males. When asked about unwanted sexual advances, 29.6 of the women and 15 percent of the males reported being subjected to sexual advances.

In this particular study, 15 percent reported being physically harmed while at work during the course of care, 16 percent comprised by females and 13.5 percent of males. The researchers noted that some analyses show 24.4 percent healthcare workers globally, and 37.3 percent in North America have reported physical violence while doing their jobs. In 2019, there were approximately 13,000 nonfatal occupational intentional injuries to healthcare workers by non-employees.

The researchers found an exposure response association between the frequency of mistreatment and the prevalence of high emotional exhaustion, high depersonalization, and overall burnout. For instance, with the increase of offensive remarks from never to several times a week, the researchers observed an increase in the percentage of participants with high emotional exhaustion from 28.6 percent to 67.6 percent. Those with high depersonalization increased from 19.8 percent to 56.7 percent. Those with overall burnout increased from 34.5 percent to 76.7 percent. Increases were seen in the burnout scores as well, with emotional exhaustion scores increasing by an average of 14 points, and depersonalization scores increasing by an average of 8 points.

The researchers concluded that mistreatment and discrimination by patients and their families commonly happened in the course of care, and such incidents were directly associated with burnout. Researchers believe that more efforts need to be made to lesson physician burnout, and such efforts should also make a concerted effort to directly address patient and visitor conduct.

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