Understanding the Origins and Factors of Burnout in Physical Medicine and Rehabilitation: Grounded Theory Analysis.

IF 3.1 Q2 Medicine

JMIR Rehabilitation and Assistive Technologies Pub Date : 2026-02-26 DOI:10.2196/80499

Robert Simpson, Eva Cohen, Stephanie Posa, Marina Wasilewski, Anthony Feinstein, Mark Bayley, Larry Robinson, Sarah Munce, Carolyn Steele Gray, Kristina Kokorelias

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Abstract

Background: Physician burnout is highly prevalent in Physical Medicine and Rehabilitation (PM&R), but its origins and drivers remain poorly understood.

Objective: This study aims to explore the factors contributing to burnout among Canadian physiatrists.

Methods: Using Charmaz's Constructed Grounded Theory within a qualitative interpretivist paradigm, we interviewed 30 Canadian physiatrists about their experiences with burnout. Analysis was informed by Cooley's looking-glass self theory.

Results: Burnout in PM&R in Canada stems from a medical culture prioritizing academic excellence over compassionate care. Canadian physiatrists report shame and self-criticism when unable to meet these high standards. Retrospective accounts from Canadian physiatrists suggest that burnout peaks during residency, where autonomy is low and demands are high. Participants also described feeling unprepared to handle patients' emotional needs and experiencing moral distress when necessary care cannot be delivered due to systemic barriers. Health care bureaucracy further compounds burnout.

Conclusions: Addressing burnout in PM&R in Canada requires upstream systemic and contemporary cultural change.

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了解物理医学与康复中职业倦怠的成因及影响因素：扎根理论分析。

背景：医生职业倦怠在物理医学和康复（PM&R）中非常普遍，但其起源和驱动因素仍然知之甚少。目的：探讨加拿大物理医师职业倦怠的影响因素。方法：在定性解释主义范式下，运用Charmaz的构建扎根理论，我们采访了30名加拿大物理医生，了解他们的职业倦怠经历。库利的镜子自我理论为分析提供了依据。结果：加拿大PM&R的职业倦怠源于医学文化优先考虑学术卓越而不是富有同情心的护理。加拿大的理疗师表示，当无法达到这些高标准时，他们会感到羞耻和自我批评。来自加拿大理疗师的回顾性研究表明，住院医师在自主性低、要求高的情况下，倦怠达到顶峰。参与者还描述了在处理病人的情感需求时感到措手不及，当由于系统障碍而无法提供必要的护理时，他们会感到道德上的痛苦。医疗保健的官僚作风进一步加剧了倦怠。结论：解决加拿大PM&R中的职业倦怠需要上游系统性和当代文化变革。

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