Background: Nationwide death by suicide burnout continues to rise in physicians (1). The key drivers of burnout are increased emotional exhaustion (EE) and depersonalization (DP) and low levels of personal accomplishment(PA). In a 2014 the Annals of Family Medicine survey revealed that 73% of general internists would not choose the same specialty again, attributing burnout as the reason (2). In our 101 member hospital medicine division, we have the opportunity to engage in various areas of research and education. Despite these outlets a high percentage of our faculty reported feeling burnt out. In 2016, sixty eight percent reported burnout in our hospital medicine division.
Methods: In, May of 2018, a wellness committee formed and initiated gratitude and athletic nights. In May of 2019, we administered the Maslach Burnout Inventory – Human Services Survey (MBI-HSS) for Medical Personnel to measure EE, DP and PA in our faculty. The MBI is proprietary and was purchased out of our division funds. Forty five, respondents rated their burnout on a 0-6 Likert scale on the 22-item survey. Results were analyzed using the independent samples T test in MBI Manual (4th edition) provided by Mind Garden, Inc. Interventions in gratitude, resilience and wellness were continued and administered a survey to assess the impact of our individual interventions.
Results: We used the sum of each scale (EE, DP and PA) as scale scores. The group’s mean score for EE was 24.58, 9.96 for DP, and 39.18 for PA. The mean scores were on par with the normative data for occupational subgroup of medicine (n=1104) provided by the MBI Manual. The Independent Samples T Test, revealed no statistically significant difference between genders in all three scales (EE, DP and PA). A statistically significant difference between faculty at 4-6 years after medical school and 7-9 years and 10-12 years after medical school in DP and PA scales exists. EE and DP decrease and PA increases, as the years out of medical school increase. There is a trend to higher degrees of burnout with rise in clinical FTE. We used the mean for the items that make up each score scales and put the participants into five profile types using the method established by Leiter and Maslach (2016) to rate burnout levels. 51% were in engaged, 20% in ineffective, 16% in burnout and 13% in the overextended profile type. The burnout and ineffective profiles were highest in the group with 4-6 years from medical degree but the proportion of these profile types decrease as the years from medical school increase until 12 years. Sports nights decreased burnout most.
Conclusions: The data supports our interventions to have junior faculty set career goals, formation of a women in medicine group, gratitude and mindfulness workshops,athletic nights and hiring nurses to complete bureaucratic tasks. We will re-administer the MBI-HHS in one year to assess the change in our burnout rate with these interventions. We have also expanded our scope to decrease staff burnout as well.