Association of well-being-centered leadership with burnout and professional fulfillment among physicians: mediating effects of autonomy support and self-valuation.

Abstract

Purpose: This study aims to investigate autonomy support and self-valuation as potential mechanisms by which supportive leadership improves physician well-being. Supportive leadership is one of the strongest predictors of physician well-being. However, mechanisms by which leadership behavior influences well-being remain unknown. The authors hypothesized that autonomy support and self-valuation mediate this relationship.

Design/methodology/approach: This was a cross-sectional survey-based study of physicians in a tri-hospital cardiovascular health system in southwestern USA. An anonymized multidimensional questionnaire comprising standardized and pre-validated measures of leadership behavior, self-valuation, autonomy support, fulfillment and burnout was e-mailed to 815 eligible physicians in February 2024. Hypothesized multivariable pathways were investigated via structural equation modeling.

Findings: In total, 122 participants answered the survey, 99 providing complete responses. Respondents were 75.76% male, 54.54% aged 41 to < 65 years, 44.44% white, 21.21% Asian and 52.52% in practice for ≥ 15 years. Reliabilities of ordinal scales were all ≥ 0.700, and univariate correlations were in expected directions. Fully, 24.24% of respondents were burned out, 63.64% professionally fulfilled, 70.71% had high autonomy support and 55.56% high self-valuation. Indirect effects of leadership support on fulfillment and burnout, mediated via autonomy support and self-valuation, were more significant than direct effects. Findings supported the study hypothesis that leadership support improves fulfillment and reduces burnout among physicians partly by fostering autonomy and self-valuation.

Originality/value: Autonomy support and self-valuation within physician teams are highlighted as factors whose improvement well-being-centered leadership training programs specifically should target.