Shanafelt Tait D, West Colin P, Sloan Jeff A, Novotny Paul J, Poland Greg A, Menaker Ron, Rummans Teresa A, Dyrbye Lotte N
Departments of Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Arch Intern Med. 2009 May 25;169(10):990-5. doi: 10.1001/archinternmed.2009.70.
Extensive literature documents personal distress among physicians and a decrease in their satisfaction with the practice of medicine over recent years. We hypothesized that physicians who spent more of their time in the aspect of work that they found most meaningful would have a lower risk of burnout.
Faculty physicians in the Department of Internal Medicine at a large academic medical center were surveyed in the fall of 2007. The survey evaluated demographic variables, work characteristics, and career satisfaction. Burnout was measured using the Maslach Burnout Inventory. Additional questions evaluated which professional activity (eg, research, education, patient care, or administration) was most personally meaningful and the percentage of effort that was devoted to each activity.
Of 556 physicians sampled, 465 (84%) returned surveys. A majority (68%) reported that patient care was the aspect of work that they found most meaningful, with smaller percentages reporting research (19%), education (9%), or administration (3%) as being most meaningful. Overall, 34% of faculty members met the criteria for burnout. The amount of time spent working on the most meaningful activity was strongly related to the risk of burnout. Those spending less than 20% of their time (approximately 1 d/wk) on the activity that is most meaningful to them had higher rates of burnout (53.8% vs 29.9%; P<.001). Time spent on the most meaningful activity was the largest predictor of burnout on multivariate analysis (odds ratio, 2.75; P = .001).
The extent to which faculty physicians are able to focus on the aspect of work that is most meaningful to them has a strong inverse relationship to their risk of burnout. Efforts to optimize career fit may promote physician satisfaction and help to reduce attrition among academic faculty physicians.
大量文献记录了近年来医生的个人困扰以及他们对医疗实践满意度的下降。我们假设,在他们认为最有意义的工作方面花费更多时间的医生职业倦怠风险较低。
2007年秋季对一家大型学术医疗中心内科的教职医生进行了调查。该调查评估了人口统计学变量、工作特征和职业满意度。使用马氏职业倦怠量表测量职业倦怠。其他问题评估了哪项专业活动(如研究、教育、患者护理或管理)对个人最有意义以及投入到每项活动的时间比例。
在抽取的556名医生中,465名(84%)回复了调查问卷。大多数(68%)报告称患者护理是他们认为最有意义的工作方面,报告研究(19%)、教育(9%)或管理(3%)最有意义的比例较小。总体而言,34%的教职员工符合职业倦怠标准。在最有意义的活动上花费的时间与职业倦怠风险密切相关。那些在对他们最有意义的活动上花费不到20%时间(约每周1天)的人职业倦怠率更高(53.8%对29.9%;P<0.001)。在多变量分析中,在最有意义的活动上花费的时间是职业倦怠的最大预测因素(优势比,2.75;P = 0.001)。
教职医生能够专注于对他们最有意义的工作方面的程度与他们的职业倦怠风险呈强烈负相关。优化职业匹配的努力可能会提高医生的满意度,并有助于减少学术教职医生的流失。