Department of Health Policy and Management, University of Maryland, College Park, School of Public Health, Maryland, 20742, USA.
Association of American Medical Colleges, 655 K St. NW Suite 100, Washington DC, USA.
BMC Med Educ. 2022 Apr 26;22(1):316. doi: 10.1186/s12909-022-03327-5.
Physicians report increasing burnout and declining career-related satisfaction, negatively impacting physician well-being and patient care quality. For physicians with academic affiliations, these issues can directly affect future generations of physicians. Previous research on burnout and satisfaction has focused on factors like work hours, gender, race, specialty, and work setting. We seek to contribute to the literature by examining these associations while controlling for demographic, family, and work-related characteristics. Furthermore, we aim to determine any differential effects of faculty rank.
We analyzed data on practicing physicians in the U.S. from the Association of American Medical College's (AAMC) 2019 National Sample Survey of Physicians (NSSP,) which includes variables adapted from the Maslach Burnout Inventory. We used ordinal logistic regressions to explore associations between academic affiliation and burnout. We conducted a factor analysis to consolidate satisfaction measures, then examined their relationship with academic affiliation using multivariate linear regressions. All regression analyses controlled for physicians' individual, family, and work characteristics.
Among respondents (n = 6,000), 40% were affiliated with academic institutions. Physicians with academic affiliations had lower odds than their non-affiliated peers for feeling emotional exhaustion every day (Odds Ratio [OR] 0.87; 95% CI: 0.79-0.96; P < .001) and reported greater career-related satisfaction (0.10-0.14, SE, 0.03, 0.02; P < .001). The odds of feeling burnt out every day were higher for associate professors, (OR 1.57; 95% CI: 1.22-2.04; P < .001) assistant professors, (OR 1.64; 95% CI: 1.28-2.11; P < .001), and instructors (OR 1.72; 95% CI, 1.29-2.29; P < .001), relative to full professors.
Our findings contribute to the literature on burnout and career satisfaction by exploring their association with academic affiliation and examining how they vary among different faculty ranks. An academic affiliation may be an essential factor in keeping physicians' burnout levels lower and career satisfaction higher. It also suggests that policies addressing physician well-being are not "one size fits all" and should consider factors such as academic affiliation, faculty rank and career stage, gender identity, the diversity of available professional opportunities, and institutional and social supports. For instance, department chairs and administrators in medical institutions could protect physicians' time for academic activities like teaching to help keep burnout lower and career satisfaction higher.
医生报告称职业倦怠和职业相关满意度下降，这对医生的健康和患者护理质量产生了负面影响。对于有学术背景的医生来说，这些问题可能会直接影响到未来几代医生。以前关于职业倦怠和满意度的研究主要集中在工作时间、性别、种族、专业和工作环境等因素上。我们希望通过在控制人口统计学、家庭和工作相关特征的情况下研究这些关联，为文献做出贡献。此外，我们旨在确定教师职级的差异影响。
我们分析了美国医学协会（AAMC）2019 年全国医生抽样调查（NSSP）中执业医生的数据，该调查包括了来自 Maslach 职业倦怠量表的变量。我们使用有序逻辑回归来探索学术背景与职业倦怠之间的关联。我们进行了一项因素分析来整合满意度衡量标准，然后使用多元线性回归来研究它们与学术背景的关系。所有回归分析均控制了医生的个人、家庭和工作特征。
在受访者（n=6000）中，40%的人有学术背景。与非附属医生相比，有学术背景的医生每天感到情绪疲惫的可能性较低（优势比 [OR] 0.87；95%置信区间：0.79-0.96；P<.001），并且报告的职业相关满意度更高（0.10-0.14，SE，0.03，0.02；P<.001）。副教授（OR 1.57；95%置信区间：1.22-2.04；P<.001）、助理教授（OR 1.64；95%置信区间：1.28-2.11；P<.001）和讲师（OR 1.72；95%置信区间：1.29-2.29；P<.001）每天感到倦怠的可能性高于正教授。
我们的研究结果通过探索职业倦怠和职业满意度与学术背景的关联，并研究它们在不同教师职级之间的差异，为职业倦怠和职业满意度的文献做出了贡献。学术背景可能是保持医生职业倦怠水平较低和职业满意度较高的重要因素。这也表明，解决医生健康问题的政策并非“一刀切”，应考虑学术背景、教师职级和职业阶段、性别认同、专业机会的多样性、机构和社会支持等因素。例如，医疗机构的系主任和管理人员可以保护医生的时间用于教学等学术活动，以帮助降低职业倦怠感并提高职业满意度。
