Sinsky Christine A, Dyrbye Lotte N, West Colin P, Satele Daniel, Tutty Michael, Shanafelt Tait D
American Medical Association, Chicago, IL.
Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2017 Nov;92(11):1625-1635. doi: 10.1016/j.mayocp.2017.08.017. Epub 2017 Nov 1.
To evaluate the relationship between burnout, satisfaction with electronic health records and work-life integration, and the career plans of US physicians.
Physicians across all specialties in the United States were surveyed between August 28, 2014, and October 6, 2014. Physicians provided information regarding the likelihood of reducing clinical hours in the next 12 months and the likelihood of leaving current practice within the next 24 months.
Of 35,922 physicians contacted, 6880 (19.2%) returned surveys. Of the 6695 physicians in clinical practice at the time of the survey (97.3%), 1275 of the 6452 who responded (19.8%) reported it was likely or definite that they would reduce clinical work hours in the next 12 months, and 1726 of the 6496 who responded (26.6%) indicated it was likely or definite that they would leave their current practice in the next 2 years. Of the latter group, 126 (1.9% of the 6695 physicians in clinical practice at the time of the survey) indicated that they planned to leave practice altogether and pursue a different career. Burnout (odds ratio [OR], 1.81; 95% CI, 1.49-2.19; P<.001), dissatisfaction with work-life integration (OR, 1.65; 95% CI, 1.27-2.14; P<.001), and dissatisfaction with the electronic health record (OR, 1.44; 95% CI, 1.16-1.80; P=.001) were independent predictors of intent to reduce clinical work hours and leave current practice.
Nearly 1 in 5 US physicians intend to reduce clinical work hours in the next year, and roughly 1 in 50 intend to leave medicine altogether in the next 2 years to pursue a different career. If physicians follow through on these intentions, it could profoundly worsen the projected shortage of US physicians.
评估职业倦怠、对电子健康记录的满意度以及工作与生活的融合度与美国医生职业规划之间的关系。
2014年8月28日至10月6日期间,对美国所有专业的医生进行了调查。医生提供了有关未来12个月内减少临床工作时长的可能性以及未来24个月内离开当前执业岗位的可能性的信息。
在联系的35922名医生中,6880名(19.2%)回复了调查问卷。在调查时从事临床工作的6695名医生中(97.3%),6452名回复者中的1275名(19.8%)报告称他们很可能或肯定会在未来12个月内减少临床工作时长,6496名回复者中的1726名(26.6%)表示很可能或肯定会在未来2年内离开当前的执业岗位。在后一组中,126名(占调查时从事临床工作的6695名医生的1.9%)表示他们计划完全离开医疗行业并追求不同的职业。职业倦怠(优势比[OR],1.81;95%置信区间[CI],1.49 - 2.19;P <.001)、对工作与生活融合度的不满(OR,1.65;95% CI,1.27 - 2.14;P <.001)以及对电子健康记录的不满(OR,1.44;95% CI,1.16 - 1.80;P =.001)是减少临床工作时长和离开当前执业岗位意愿的独立预测因素。
近五分之一的美国医生打算在明年减少临床工作时长,约五十分之一的医生打算在未来两年内完全离开医疗行业去追求不同的职业。如果医生贯彻这些想法,可能会使预计的美国医生短缺情况严重恶化。