Background: Physician burnout has been suggested to be positively associated with the degree of spirituality and negatively associated with empathy; however, sparse data with mixed results are available. Therefore, our objective was to determine if physician burnout is related to spirituality and with empathy.

Methods: We surveyed attending physicians, residents, and medical students using an emailed questionnaire that included questions about demographic data and three validated tools; a burnout tool (Oldenburg Burnout Inventory [OLBI]), a spirituality tool (Daily Spiritual Experience Scale [DSES]), and an empathy tool (Interpersonal Reactivity Index [IRI]). Each item of the survey tools was scored and mean scores were calculated as recommended by survey authors. We used linear regression to examine the relationship between the two burnout domains of OLBI (exhaustion and disengagement), spirituality, four domains of IRI (perspective taking, fantasy scale, empathetic concern, and personal distress), and total IRI without and with adjustment for age, gender, race, and faculty status.

Results: Of the 101 participants, 47 (47%) were females. Mean(SD) exhaustion score was 3.2 (0.7), disengagement 3.0 (0.6), spirituality 2.8 (1.3), and total IRI score was 2.2 (0.4). In unadjusted and adjusted analyses, we found no association between both domains of OLBI and DSES or total IRI scores. Of the IRI domains, we found a strong but negative association between both domains of OLBI and the personal distress domain but not with other domains. In adjusted models,for each one-point increase in the personal distress domain, OLBI exhaustion score decreased by 0.40 (95% CI = -0.68 to -0.12; P = 0.005) and physician disengagement decreased by 0.20 (95% CI = -0.47 to -0.003; P =0.047) (Figure).

Conclusions: We did not find an association between physician burnout and spirituality, total empathy, or empathy domains except for the personal distress domain. Personal distress is a tendency to experience distress and discomfort in response to extreme distress in others. Given that this is a cross sectional study, further research is necessary to establish causality.

IMAGE 1: Scatter plot between mean Personal Distress scores with mean Disengagement and mean Exhaustion with superimposed regression lines