Yoon John D, Daley Brendan M, Curlin Farr A
University of Chicago, Chicago, IL, USA.
University of Illinois, Chicago, IL, USA.
Acad Psychiatry. 2017 Apr;41(2):167-173. doi: 10.1007/s40596-016-0487-1. Epub 2016 Jan 25.
This study assesses the association between calling and physician well-being, clinical commitment, and burnout.
In 2009-2010, a survey was mailed to 1504 primary care physicians (PCPs) and 512 psychiatrists drawn from the American Medical Association Physician Masterfile. The primary independent variable was a single-item measure that assessed physicians' level of calling. Main outcomes were markers of physician well-being (career satisfaction and morale), clinical commitment (intentions to reduce time spent in direct patient care, leave practice in a few years), and experiences of burnout.
Adjusted response rates were 63 % (896/1427) for PCPs and 64 % (312/487) for psychiatrists. Forty-two percent of US PCPs and psychiatrists agree strongly that their practice of medicine is a calling. Physicians with a high sense of calling were less likely than those with low to report regret in choosing medicine as a career (18 vs. 38 %; odds ratio 0.3; 95 % confidence interval, 0.2-0.5), wanting to go into a different clinical specialty (28 vs. 49 %; OR 0.4; 95 % CI, 0.2-0.6), or wanting to leave the practice of medicine in the next few years (14 vs. 25 %, OR 0.4; 95 % CI 0.2-0.7). Physicians with a high sense of calling were less likely to report burnout (17 vs. 31 % low calling, OR 0.4; 95 % CI 0.3 to 0.7).
Physicians who reported that medicine was a calling may be experiencing higher levels of career satisfaction, more durable clinical commitments, and resilience from burnout. Though physicians may differ on their understanding of the concept of calling in medicine, this study highlights an important factor that should be investigated further when assessing long-term workforce retention in the fields of primary care and psychiatry.
本研究评估使命感与医生幸福感、临床投入度及职业倦怠之间的关联。
2009 - 2010年，向从美国医学协会医生主档案库抽取的1504名初级保健医生（PCP）和512名精神科医生邮寄了一份调查问卷。主要自变量是一项评估医生使命感水平的单项指标。主要结果是医生幸福感（职业满意度和士气）、临床投入度（减少直接患者护理时间的意向、几年内离开执业岗位的意向）以及职业倦怠经历的指标。
初级保健医生的调整后回复率为63%（896/1427），精神科医生为64%（312/487）。42%的美国初级保健医生和精神科医生强烈认同他们的医学实践是一种使命。使命感强的医生比使命感弱的医生更不容易报告在选择医学作为职业时感到后悔（18%对38%；优势比0.3；95%置信区间，0.2 - 0.5），更不容易表示想进入不同的临床专科（28%对49%；OR 0.4；95% CI，0.2 - 0.6），或者在未来几年内想离开医学实践（14%对25%，OR 0.4；95% CI 0.2 - 0.7）。使命感强的医生报告职业倦怠的可能性更低（使命感弱的为31%，使命感强的为17%；OR 0.4；95% CI 0.3至0.7）。
报告医学是一种使命的医生可能体验到更高水平的职业满意度、更持久的临床投入度以及对职业倦怠的恢复力。尽管医生对医学使命感概念的理解可能存在差异，但本研究突出了一个重要因素，在评估初级保健和精神病学领域的长期劳动力留存时应进一步调查。
