Background: Physician burnout is a ubiquitous problem in healthcare characterized by emotional exhaustion, depersonalization, and a sense of reduced accomplishment from daily work. Though research has been done to evaluate the national burden of burnout in hospitalists, the impact of specific drivers of burnout and engagement is not yet well described. Drivers identified in the literature include workload and job demands, efficiency and resources, meaning in work, culture and values, control and flexibility, social support and community at work, and work-life integration. Evaluation of institutional and individual factors on physician wellbeing is a gap in the literature. This survey was intended to identify areas for improvement across community and academic hospital sites in a large Southern health system. We sought to determine which drivers of burnout/engagement had the greatest impact on hospitalists and how demographics or work environment might influence their responses.

Methods: Hospitalist physicians and Advanced Practice Providers at 8 sites were surveyed about demographics, satisfaction with drivers of engagement/burnout, and their personal state of burnout. All drivers were individually assessed. Logistic regression was used to determine associations between demographics and categories of burnout.

Results: Overall, 41 of 210 eligible respondents completed the survey (19.5% response rate). Most respondents were physicians (95%), between ages 31 and 50 (86.3%), White (48.8%) or Asian (27.9%), male gender (52.3%), living with a significant other (81.4%), and living with ≥1 dependent child (56.8%). A total of 37.5% of respondents reported high professional fulfillment (raw Likert scale scores [0-4] were dichotomized at 3 to indicate fulfilled vs not fulfilled), and 35% met criteria for burnout (also dichotomized on a scale of 1-4). Respondents were asked to rate satisfaction with individual drivers using a 5-point Likert scale. There were three categories where half or more of the respondents rated their satisfaction less than “a lot” or “extremely satisfied”: workload and job demands (50%), work-life integration (52.3%), and culture and values of the healthcare organization (53.3%). Respondents were then asked to identify the driver they were most and least satisfied with. The most frequently selected driver for satisfaction was the “meaning I find in work” (22%) and the most frequently selected for dissatisfaction was “workload and job demands” (35.7%). Male gender, age >40, living with a significant other, and living with dependent children were all associated with lower scores in various categories of burnout, indicating they were possibly protective against burnout (p<.05).

Conclusions: Components of burnout are present in a significant subset of this hospitalist population; several areas for intervention were identified. Further evaluation is necessary to characterize how responses change as individual and institutional reforms are implemented to combat burnout.