Mayo docs cutting work hours to cope with burnout

Mayo Clinic researchers have taken a close look at the professional effort of their institution’s own physicians in Minnesota, Arizona and Florida—and found a strong association between high burnout levels and reduced work hours.

Assuming the three-region study cohort is at least roughly representative of the U.S. physician population as a whole, the results suggest that the less satisfaction American doctors draw from their profession these days, the more they tend to cut back on their workloads—just as the country is facing widely accepted projections of a coming physician shortage.

Led by Mayo hematologist and oncologist Tait Shanafelt, MD, the researchers drew from administrative and payroll records to track professional effort, measured as FTE units worked, from October 2008 to October 2014.

The team also longitudinally surveyed Mayo physicians twice during the study period, using standardized tools to assess job satisfaction and burnout levels.

Some 1,856 physicians completed the survey in 2011 (69.7 percent of 2,663 who were sent a survey), and 2,132 (76.9 percent of 2,776) responded in 2013.

Shanafelt et al. published the results April 1 in Mayo Clinic Proceedings.

Their key findings:

• Between 2008 and 2014, the proportion of physicians working less than full-time at Mayo increased from 13.5 percent to 16.0 percent.  
• Burnout and satisfaction scores in 2011 correlated with actual reductions in FTE over the following 24 months as independently measured by administrative and payroll records.
• After controlling for age, sex, site and specialty, each 1-point increase in the 7-point emotional exhaustion scale was associated with a greater likelihood of reducing FTE over the following 24 months, and each 1-point decrease in the 5-point satisfaction score was associated with greater likelihood of reducing FTE.
• On longitudinal analysis at the individual physician level, each 1-point increase in emotional exhaustion or 1-point decrease in satisfaction between 2011 and 2013 was associated with a greater likelihood of reducing FTE over the following 12 months.

In their discussion, the authors note that, while cutting back on work hours may well help individual physicians improve their personal well-being, the decision “has the potential to exacerbate the already substantial U.S. physician workforce shortage and could also impact continuity of care for patients.”

Physicians reducing their professional effort “may also compound the challenge that many medical centers have in preserving adequate patient access to physicians—particularly primary care physicians,” they write. “It is notable that primary care physicians, who experience some of the highest rates of professional burnout, were more likely to work part-time across all years of our study.”

Mayo has posted the full study.