Background: Current studies continue to find high rates of reported burnout worldwide among healthcare workers, including attending physicians. However, many of the studies have been limited in assessing attending physician well-being across multiple sites and healthcare systems. Within our health enterprise, we have a diverse group of attending physicians, particularly those who rotate on the inpatient general medicine teaching services. This group is comprised of hospitalists and general internists, who rotate on the inpatient services for various durations at our tertiary medical centers and community hospitals. The purpose of our study was to evaluate the attending physician’s experience, attitude and perceptions on the inpatient general medicine teaching services at Atrium Health Carolinas Medical Center (AHCMC) and Atrium Health Wake Forest Baptist (AHWFB), which includes Atrium Health Wake Forest Baptist Medical Center and Atrium Health High Point Medical Center.
Methods: After IRB approval was secured, all attending physicians supervising the inpatient general medicine teaching services at three institutions across our enterprise from July 1, 2022 – June 30, 2023, were invited to participate in the study. A 28-question survey was distributed via RedCap with up to three reminders over a 6-week period. All survey responses were anonymous and confidential. The survey results were also analyzed by a neutral third party using descriptive analysis with Fisher’s Exact tests utilized to assess differences in group responses.
Results: 30 out of 54 attending physicians completed the survey (response rate of 56%). 12 (40%) of the attendings were based at AHCMC and 18 (60%) of the attendings were based at AHWFB. Attendings who were the primary caregiver to a family member (e.g., adult, child) or friend were more likely to experience feelings of depersonalization (p=0.031). Also, attendings who had < 10 years of experience at their current institution were more likely to report having feelings of emotional exhaustion due to their work (p=0.041). Further, attendings with >10 weeks of inpatient service were more likely to report feelings of emotional exhaustion (p=0.041) and depersonalization (p=0.012). Moreover, attendings with protected administrative time had reduced feelings of emotional exhaustion due to work (p=0.054), but they felt that non-patient care obligations (e.g., meetings, research) affected their ability to effectively teach the residents and students on the team (p=0.020). Lastly, attendings across the sites had no difference in feelings of emotional exhaustion, depersonalization, or reduced personal achievement (p=0.06, p=0.63, p=0.75, respectively).
Conclusions: To the best of our knowledge, this is the first study to assess attending physician experience, attitude and perceptions for those on inpatient general medicine teaching services across an academic learning health system. Symptoms of burnout were identified in those attending physicians who were the primary caregiver to a family member or friend, had less experience at their current institution (< 10 years), and had more inpatient service (>10 weeks). Further, those with protective administrative time felt that non-patient care obligations such as meetings affected their ability to effectively teach the learners on the team. Attention to these particular groups may be warranted to help improve attending physician well-being and professional fulfillment.