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Two-Thirds of Surveyed Ob.Gyns. Suffer Burnout : Higher rates of burnout were reported in women and African Americans.


 

SAN FRANCISCO — A survey of ob.gyns. from Delaware, New Jersey, and Pennsylvania revealed that almost two-thirds suffer the symptoms of burnout, Vincent A. Pellegrini, M.D., reported at the annual meeting of the American College of Obstetricians and Gynecologists.

All ACOG members in District III were surveyed in 2004, and 863 responded, for a response rate of 30%, reported Dr. Pellegrini, who is in private practice in West Reading, Pa. Of those physicians, 64% reported the symptoms of burnout, as judged by the Maslach Burnout Inventory. Burnout is defined as a syndrome of physical, emotional, and attitudinal exhaustion.

A total of 40% of respondents said they plan to retire early because of today's medical environment, 29% said they were physically exhausted, and 16% said they wanted to quit medicine, Dr. Pellegrini said. All those responses had a significant positive correlation with burnout symptoms.

Of the full sample, 49% said they would encourage their children to go into medicine, but only 23% said they themselves would again make the decision to go to medical school. Twenty percent said that they were satisfied with their practice situation, and 16% said that they were satisfied with being a physician.

Only 27% were comfortable with their balance between work and family. That could be due in part to the long hours most ob.gyns. work. On average, they're working 59 hours per week, not counting nights on call.

Physicians under age 50 were significantly more likely to report burnout symptoms than those age 50 or above (58% vs. 45%). “It seems that the older physicians had some type of survival factor that allowed them to find ways to cope,” Dr. Pellegrini said.

As far as manifesting symptoms of burnout, women appear to be faring worse than men (70% vs. 59%), and African Americans appear to be faring worse than other ob.gyns. (78% vs. 63%). While statistically significant, both of those differences may be confounded by the lower average ages of female and African American ob.gyns.

Workload played a major role in burnout symptoms. Physicians who reported a recent increase in workload had a burnout rate of 76%, while it was 46% for the few who reported a decrease in workload. Those who reported working full time had a 69% burnout rate, while it was 47% for those working part time.

The practice of obstetrics had a significant impact on burnout. The burnout rate was 70% among physicians still doing obstetrics but only 51% among those who had dropped obstetrics from their practice.

Given that, it's perhaps surprising that the survey uncovered no significant correlation between burnout and lawsuits. Fully 82% of the people who responded have had lawsuits filed against them, an average of 3.8 lawsuits apiece, with a range of 1–20.

Ob.gyns. with spouses who worked outside the home had a 66% burnout rate, while those with spouses who did not work outside the home had a 58% burnout rate. Among physicians who had children between the primary grades and college, there was a 72% burnout rate. But having younger or older children did not correlate significantly with burnout.

Dr. Pellegrini listed a number of factors that appeared to protect against burnout, and he divided them into controllable and less controllable categories.

Among the controllable factors are regular exercise, adequate sleep, working part time, practicing gynecology only, allowing 45 minutes for each new patient, and being connected to the community.

Among the less controllable factors are being older, being male, working in an academic environment, feeling adequately compensated, and having compatible colleagues.

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