Shanafelt Tait D, Boone Sonja, Tan Litjen, Dyrbye Lotte N, Sotile Wayne, Satele Daniel, West Colin P, Sloan Jeff, Oreskovich Michael R
Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Arch Intern Med. 2012 Oct 8;172(18):1377-85. doi: 10.1001/archinternmed.2012.3199.
Despite extensive data about physician burnout, to our knowledge, no national study has evaluated rates of burnout among US physicians, explored differences by specialty, or compared physicians with US workers in other fields.
We conducted a national study of burnout in a large sample of US physicians from all specialty disciplines using the American Medical Association Physician Masterfile and surveyed a probability-based sample of the general US population for comparison. Burnout was measured using validated instruments. Satisfaction with work-life balance was explored.
Of 27 276 physicians who received an invitation to participate, 7288 (26.7%) completed surveys. When assessed using the Maslach Burnout Inventory, 45.8% of physicians reported at least 1 symptom of burnout. Substantial differences in burnout were observed by specialty, with the highest rates among physicians at the front line of care access (family medicine, general internal medicine, and emergency medicine). Compared with a probability-based sample of 3442 working US adults, physicians were more likely to have symptoms of burnout (37.9% vs 27.8%) and to be dissatisfied with work-life balance (40.2% vs 23.2%) (P < .001 for both). Highest level of education completed also related to burnout in a pooled multivariate analysis adjusted for age, sex, relationship status, and hours worked per week. Compared with high school graduates, individuals with an MD or DO degree were at increased risk for burnout (odds ratio [OR], 1.36; P < .001), whereas individuals with a bachelor's degree (OR, 0.80; P = .048), master's degree (OR, 0.71; P = .01), or professional or doctoral degree other than an MD or DO degree (OR, 0.64; P = .04) were at lower risk for burnout.
Burnout is more common among physicians than among other US workers. Physicians in specialties at the front line of care access seem to be at greatest risk.
尽管有大量关于医生职业倦怠的数据，但据我们所知，尚无全国性研究评估美国医生的职业倦怠率、探讨不同专业之间的差异，或比较医生与美国其他领域工作者的情况。
我们利用美国医学协会医生主档案对来自所有专业学科的大量美国医生样本进行了一项全国性职业倦怠研究，并对美国普通人群的一个基于概率的样本进行了调查以作比较。使用经过验证的工具来衡量职业倦怠。探讨了对工作与生活平衡的满意度。
在收到参与邀请的27276名医生中，7288名（26.7%）完成了调查。使用马氏职业倦怠量表进行评估时，45.8%的医生报告至少有1种职业倦怠症状。不同专业的职业倦怠存在显著差异，在医疗服务一线的医生（家庭医学、普通内科和急诊医学）中职业倦怠率最高。与3442名在职美国成年人的基于概率的样本相比，医生更有可能出现职业倦怠症状（37.9%对27.8%），并且对工作与生活平衡不满意（40.2%对23.2%）（两者P均<0.001）。在对年龄、性别、婚姻状况和每周工作时长进行调整的汇总多变量分析中，完成的最高教育水平也与职业倦怠有关。与高中毕业生相比，拥有医学博士或医学博士学位的个体职业倦怠风险增加（优势比[OR]，1.36；P<0.001），而拥有学士学位（OR，0.80；P = 0.048）、硕士学位（OR，0.71；P = 0.01）或医学博士或医学博士学位以外的专业或博士学位（OR，0.64；P = 0.04）的个体职业倦怠风险较低。
职业倦怠在医生中比在美国其他工作者中更为常见。处于医疗服务一线专业的医生似乎风险最大。
