Ghaseminejad Farhad, Rich Kira, Rosenbaum Debbie, Rydz Emilia, Chow Lawrence, Salmon Amy, Palepu Anita, Dodek Peter, Leitch Heather A, Townson Andrea, Lacaille Diane, Varshney Vishal, Stanger Elizabeth, Khan Nadia
The University of British Columbia, Vancouver, British Columbia, Canada
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
BMJ Open. 2025 Jan 28;15(1):e085973. doi: 10.1136/bmjopen-2024-085973.
To identify physician perspectives on factors associated with physician burnout, protective factors against burnout, and to seek potential solutions for this pervasive problem.
A qualitative study with semistructured focus group interviews using a systematic framework analysis.
Physicians from general internal medicine (GIM) and the emergency department (ED) at two urban tertiary care hospitals in Vancouver, Canada, were recruited. Separate GIM and ED physician focus groups were conducted virtually from July 2021 to December 2022, led by an independent facilitator. Audio recordings from focus group sessions were then transcribed for analysis.
41 physicians (29 GIM and 12 ED) participated in the focus groups. The dominant themes for organisational factors attributed to burnout that were highlighted by both groups included heavy workload and scheduling, frequent interruptions, interdepartmental conflict and feeling undervalued by leadership. Other contributing factors that were only emphasised by GIM physicians were pressure to work out-of-scope of their practice, pressure to admit and discharge patients quickly, as well as sexism in the workplace. Factors unique to ED physicians included experiencing violence in the workplace and having to assess patients in waiting rooms. Protective organisational factors included time to build rapport with patients, staff collegiality, working within their scope of practice, and feeling rewarded and valued by leadership. Interventions suggested by physicians included improving channels of communication between staff, increasing flexibility in scheduling and strengthening hospitalists' services.
Most organisational factors driving burnout were common to both GIM and ED physicians, including heavy workload and scheduling, frequent interruptions, interdepartmental conflict and feeling undervalued by leadership. Leveraging protective factors and intervening on organisational factors attributed to burnout such as improving communication and enhancing support services may be effective in addressing the physician burnout epidemic.
确定医生对与职业倦怠相关因素、预防职业倦怠的保护因素的看法，并寻找解决这一普遍问题的潜在方案。
采用系统框架分析的半结构化焦点小组访谈进行定性研究。
招募了加拿大温哥华两家城市三级护理医院的普通内科（GIM）和急诊科（ED）的医生。2021年7月至2022年12月期间，由一名独立主持人以虚拟方式分别组织了GIM和ED医生焦点小组。然后将焦点小组会议的录音转录进行分析。
41名医生（29名GIM医生和12名ED医生）参与了焦点小组。两组都强调的导致职业倦怠的组织因素的主要主题包括工作量大与排班、频繁中断、部门间冲突以及感觉未得到领导重视。GIM医生仅强调的其他促成因素包括超出执业范围工作的压力、快速收治和出院患者的压力以及工作场所的性别歧视。ED医生特有的因素包括在工作场所遭受暴力以及必须在候诊室评估患者。保护性组织因素包括有时间与患者建立融洽关系、员工之间的融洽相处、在执业范围内工作以及感觉得到领导的奖励和重视。医生建议的干预措施包括改善员工之间的沟通渠道、增加排班灵活性以及加强住院医师服务。
导致职业倦怠的大多数组织因素在GIM和ED医生中都很常见，包括工作量大与排班、频繁中断、部门间冲突以及感觉未得到领导重视。利用保护因素并针对导致职业倦怠的组织因素进行干预，如改善沟通和加强支持服务，可能有效地解决医生职业倦怠问题。
