Evans Randolph W, Ghosh Kamalika
Department of Neurology, Baylor College of Medicine, 1200 Binz #1370, Houston, TX, 77004.
Department of Psychology, Rice University, 6100 Main Street, MS-25, Houston, TX, 77005.
Headache. 2015 Nov-Dec;55(10):1448-57. doi: 10.1111/head.12708. Epub 2015 Oct 15.
Physicians report increasing rates of career dissatisfaction and professional burnout, which may be related to the practice environment and subspecialty. There has never been a survey of professional burnout among headache medicine specialists.
The aim of the present survey was to learn more about how headache medicine physicians are affected by these issues.
An email survey was sent to 749 physician members of the American Headache Society with questions or statements about demographics, professional quality of life and satisfaction, future practice plans, and professional burnout using the Maslach Burnout Inventory.
In a sample of 127 headache medicine specialists, 66 (57.4%) physicians reported symptoms of professional burnout reflected by high Emotional Exhaustion and/or high Depersonalization. There is widespread dissatisfaction with work schedules, government regulations, implementation of the Affordable Care Act, insurance company policies, malpractice concerns, patient telephone calls, and compensation. Sixty-two percent of respondents concur that headache medicine is becoming more complicated without patient benefit, 14% concur that headache medicine specialists are fairly compensated, and 59% would go into headache medicine again if they were fourth year medical students. In the next 1 to 3 years, 21.3% plan to cut back on hours, 14.2% plan to cut back on patients seen, and 12.6% plan to switch to a cash practice. Medicine and healthcare are changing in such a way that 33.9% concur that they will accelerate their retirement plans.
Headache medicine specialists have one of the highest rates of burnout compared to other physician specialists, which is twice the rate of working adults. Physicians' age and practice environment and experience are related with their career satisfaction and professional burnout. Some attributes of career satisfaction can decrease burnout by reducing emotional exhaustion and depersonalization and by enhancing personal accomplishment. There is widespread dissatisfaction with the practice environment. These findings may portend decreasing access to headache medicine specialists in the future if specialists cut back on hours and patients seen, accelerate their retirement plans, and fewer neurologists are attracted to headache medicine.
医生报告称职业满意度和职业倦怠率不断上升，这可能与执业环境和亚专业有关。此前从未对头痛医学专家的职业倦怠情况进行过调查。
本次调查的目的是更深入了解头痛医学医生受这些问题影响的情况。
向美国头痛协会的749名医生会员发送了一份电子邮件调查问卷，问题或陈述涉及人口统计学、职业生活质量与满意度、未来执业计划以及使用马氏职业倦怠量表评估的职业倦怠情况。
在127名头痛医学专家样本中，66名（57.4%）医生报告出现职业倦怠症状，表现为高度情感耗竭和/或高度去人格化。医生们对工作时间表、政府法规、《平价医疗法案》的实施、保险公司政策、医疗事故担忧、患者来电以及薪酬普遍不满。62%的受访者认为头痛医学变得越来越复杂但患者并未从中受益，14%的受访者认为头痛医学专家薪酬合理，59%的受访者表示如果他们是四年级医学生，会再次选择从事头痛医学专业。在未来1至3年内，21.3%的人计划减少工作时长，14.2%的人计划减少看诊患者数量，12.6%的人计划转向现金诊疗模式。医学和医疗保健正在发生变化，33.9%的人认为这将促使他们加快退休计划。
与其他专科医生相比，头痛医学专家的职业倦怠率位居前列，是在职成年人倦怠率的两倍。医生的年龄、执业环境和经验与他们的职业满意度和职业倦怠有关。职业满意度的一些因素可以通过减少情感耗竭和去人格化以及增强个人成就感来降低职业倦怠。医生们对执业环境普遍不满。如果专家减少工作时长和看诊患者数量、加快退休计划，并且吸引更少的神经科医生从事头痛医学专业，这些发现可能预示着未来头痛医学专家的可及性将降低。
