Doctor burnout a risk to patient safety, finds major review

Physician burnout is a risk to safe healthcare, with burnt out doctors twice as likely to be involved in patient safety incidents as those who are not, researchers say.

The finding is based on a meta-analysis of 170 observational studies from around the world involving almost 240,000 doctors working a variety of settings.

Published in the BMJ, the review also found burnout in doctors was associated with a loss of professionalism, an almost four-fold decrease in job satisfaction and a four-fold increase in emotional exhaustion and depersonalisation.

Overall, this provided “compelling evidence” of strong links between burnout and career disengagement of physicians and suboptimal care, wrote the team of UK and European researchers.

“Many countries including the US and the UK have described levels of physician burnout as the highest in the history of health and care systems,” they wrote (link here).

“Our findings affirm that physician burnout can be a catalyst for the career disengagement of physicians and burnout is associated with unsafe patient care, which costs billions to healthcare systems annually.”

Beyond the immediate patient care concerns, they said they study also had important ramifications for health workforce planning, given that doctors with burnout were also more likely to be unhappy in their career choices and considering their jobs.

It comes amid growing awareness of the problem in Australia, with an RACP survey published last November showing 87% of members were concerned over the effect of burnout on their careers.

And in May, the college’s then president Professor John Wilson quit Victoria’s public hospital system, announcing the reason was burnout after two years of the COVID-19 pandemic.

“This decision came out of frustration,” he said at the time.

“I love my patients and I love my team and don’t wish to move away from that, however we have been asked to commit to levels of care that we are unable to achieve.

“I held my breath for as long as I could but I’m sorry, someone had to make a stand.”

In an editorial linked to the systematic review in the BMJ, Professor Matthias Weigl of Bonn University’s Institute for Patient Safety said the findings highlighted the need for health systems around the world to find solutions.

“The pervasive nature of physician burnout indicates a defective work system caused by deep societal problems and structural problems across the sector,” he wrote (link here).

“Urgent action is imperative for the safety of physicians, patients, and health systems, including interventions that are evidence based and system oriented, to design working environments that promote staff engagement and prevent burnout.”

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