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Burnout among specialists and trainees in physical medicine and rehabilitation: A systematic review

Emma A. Bateman, Ricardo Viana
Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, N6C0A7 London, Canada. E-mail: eabateman@gmail.com
DOI: 10.2340/16501977-2614

Preview of fully accepted paper, still not published in any volume

Abstract

Objective: Burnout, a state of emotional exhaustion related to work or patient-care activities, is prevalent in all stages of medical training and clinical practice. The syndrome has serious consequences, including medical errors, poorer quality of care, substance abuse, and suicide. The aim of this study is to evaluate the prevalence of burnout in Physical Medicine & Rehabilitation (PM&R) specialists and trainees.
Methods: Systematic literature searches were conducted in MEDLINE, CINAHL and EMBASE for peer-reviewed articles in English before March 2019 about the prevalence of burnout amongst PM&R specialists and trainees.
Results: This systematic review yielded 359 results. Of these, 33 full-text records were reviewed; 5 met the inclusion criteria: 3 surveys of PM&R specialists and 2 of PM&R residents (total n?=?1,886 physicians; year of publication 2012–2019). Data extracted included prevalence and severity of burnout and, if available, risk or protective factors. Data were analysed using descriptive statistics. Incidence of burnout ranged from 22.2% to 83.3% in trainees and 48% to 62% in specialists. Organizational and system challenges were the primary risk factors for burnout amongst specialists.
Conclusion: Emerging evidence positions physicians in PM&R among the most likely to experience burnout. Although there is limited literature regarding PM&R specialists and trainees, the available evidence suggests that more than half of physicians in PM&R experience burnout.

Lay Abstract

Professional burnout, emotional exhaustion and loss of satisfaction with patient care affects doctors at all stages of their career, from residency trainees to certified specialists. Burnout is a critical emerging issue facing specialists and trainees of all disciplines. Burnout in doctors is linked to serious negative outcomes for patients, including higher rates of medical errors and poorer quality of care. It is also linked to negative outcomes for doctors, including substance abuse and suicide. Although burnout is a serious problem, little is known about burnout in specialists and trainees in Physical Medicine & Rehabilitation (PM&R). Historically, it was thought that doctors in rehabilitation medicine were less likely to experience burnout than doctors in other specialties. A systematic review was conducted to understand if burnout is in fact a problem for doctors in PM&R. It was found that more than half of all rehabilitation doctors, including specialists and trainees, experience burnout; a higher rate than for non-rehabilitation doctors. Working in PM&R is a unique risk factor for burnout among doctors. Important next steps will be to understand what causes such high rates of burnout and what can be done to help.

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