Nathan Houchens, M Todd Greene, Srijan Sen, Elizabeth Harry, David Ratz, Karen E Fowler, Sanjay Saint
{"title":"美国内科医生中与幸福感和职业倦怠相关的因素：一项横断面调查。","authors":"Nathan Houchens, M Todd Greene, Srijan Sen, Elizabeth Harry, David Ratz, Karen E Fowler, Sanjay Saint","doi":"10.1136/bmjqs-2025-018813","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Because physician burnout negatively affects patients, organisations and those impacted, we aimed to identify and evaluate factors contributing to burnout among internal medicine physicians in the USA.</p><p><strong>Design: </strong>Cross-sectional survey conducted between 23 June 2023 and 8 May 2024.</p><p><strong>Setting: </strong>A national multicentre study conducted in the USA.</p><p><strong>Participants: </strong>Random sample of non-subspecialty internal medicine physicians identified through Physician Professional Data, a database maintained by the American Medical Association. Of 1421 eligible physicians, 629 (44.3%) responded.</p><p><strong>Main outcome measures: </strong>The 42-item survey collected data on multiple factors-professional environment, community and personal-hypothesised to influence well-being. Burnout domains, including emotional exhaustion, depersonalisation and reduced personal accomplishment, were measured using the Maslach Burnout Inventory-Human Services Survey.</p><p><strong>Results: </strong>A total of 9.8% (61/622) participants had extreme burnout as defined by meeting thresholds for all three burnout domains. In multivariable regression analysis, several aspects of the professional environment (eg, workload, lack of autonomy) were statistically significantly associated with elevated odds of burnout. Community factors statistically significantly associated with reduced odds of burnout included a supervisor who empowers and treats the physician with respect and dignity and greater support from organisational leaders. Mindful awareness and a sense of purpose were statistically significantly inversely associated with odds of burnout.</p><p><strong>Conclusion: </strong>Burnout among US internal medicine physicians is common and influenced by many factors. Interventions to elevate well-being should be multi-faceted and seek to reduce workload, augment autonomy, bolster support and perceptions of value from leaders and co-workers and foster environments conducive to mindful practice and sense of purpose.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":6.5000,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors associated with well-being and burnout among US internal medicine physicians: a cross-sectional survey.\",\"authors\":\"Nathan Houchens, M Todd Greene, Srijan Sen, Elizabeth Harry, David Ratz, Karen E Fowler, Sanjay Saint\",\"doi\":\"10.1136/bmjqs-2025-018813\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Because physician burnout negatively affects patients, organisations and those impacted, we aimed to identify and evaluate factors contributing to burnout among internal medicine physicians in the USA.</p><p><strong>Design: </strong>Cross-sectional survey conducted between 23 June 2023 and 8 May 2024.</p><p><strong>Setting: </strong>A national multicentre study conducted in the USA.</p><p><strong>Participants: </strong>Random sample of non-subspecialty internal medicine physicians identified through Physician Professional Data, a database maintained by the American Medical Association. Of 1421 eligible physicians, 629 (44.3%) responded.</p><p><strong>Main outcome measures: </strong>The 42-item survey collected data on multiple factors-professional environment, community and personal-hypothesised to influence well-being. Burnout domains, including emotional exhaustion, depersonalisation and reduced personal accomplishment, were measured using the Maslach Burnout Inventory-Human Services Survey.</p><p><strong>Results: </strong>A total of 9.8% (61/622) participants had extreme burnout as defined by meeting thresholds for all three burnout domains. In multivariable regression analysis, several aspects of the professional environment (eg, workload, lack of autonomy) were statistically significantly associated with elevated odds of burnout. Community factors statistically significantly associated with reduced odds of burnout included a supervisor who empowers and treats the physician with respect and dignity and greater support from organisational leaders. Mindful awareness and a sense of purpose were statistically significantly inversely associated with odds of burnout.</p><p><strong>Conclusion: </strong>Burnout among US internal medicine physicians is common and influenced by many factors. Interventions to elevate well-being should be multi-faceted and seek to reduce workload, augment autonomy, bolster support and perceptions of value from leaders and co-workers and foster environments conducive to mindful practice and sense of purpose.</p>\",\"PeriodicalId\":9077,\"journal\":{\"name\":\"BMJ Quality & Safety\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.5000,\"publicationDate\":\"2025-09-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Quality & Safety\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjqs-2025-018813\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Quality & Safety","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjqs-2025-018813","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Factors associated with well-being and burnout among US internal medicine physicians: a cross-sectional survey.
Objective: Because physician burnout negatively affects patients, organisations and those impacted, we aimed to identify and evaluate factors contributing to burnout among internal medicine physicians in the USA.
Design: Cross-sectional survey conducted between 23 June 2023 and 8 May 2024.
Setting: A national multicentre study conducted in the USA.
Participants: Random sample of non-subspecialty internal medicine physicians identified through Physician Professional Data, a database maintained by the American Medical Association. Of 1421 eligible physicians, 629 (44.3%) responded.
Main outcome measures: The 42-item survey collected data on multiple factors-professional environment, community and personal-hypothesised to influence well-being. Burnout domains, including emotional exhaustion, depersonalisation and reduced personal accomplishment, were measured using the Maslach Burnout Inventory-Human Services Survey.
Results: A total of 9.8% (61/622) participants had extreme burnout as defined by meeting thresholds for all three burnout domains. In multivariable regression analysis, several aspects of the professional environment (eg, workload, lack of autonomy) were statistically significantly associated with elevated odds of burnout. Community factors statistically significantly associated with reduced odds of burnout included a supervisor who empowers and treats the physician with respect and dignity and greater support from organisational leaders. Mindful awareness and a sense of purpose were statistically significantly inversely associated with odds of burnout.
Conclusion: Burnout among US internal medicine physicians is common and influenced by many factors. Interventions to elevate well-being should be multi-faceted and seek to reduce workload, augment autonomy, bolster support and perceptions of value from leaders and co-workers and foster environments conducive to mindful practice and sense of purpose.
期刊介绍：
BMJ Quality & Safety (previously Quality & Safety in Health Care) is an international peer review publication providing research, opinions, debates and reviews for academics, clinicians and healthcare managers focused on the quality and safety of health care and the science of improvement.
The journal receives approximately 1000 manuscripts a year and has an acceptance rate for original research of 12%. Time from submission to first decision averages 22 days and accepted articles are typically published online within 20 days. Its current impact factor is 3.281.
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