In addition to the many system factors that affect clinician burnout, individual factors, including family dynamics, financial stressors, and learning style may also increase the risk for clinicians to experience burnout.
Unbalanced Work-Life Integration
For many people, personal life outside of work offers a space to recharge from work stress. For many, if not most clinicians, balancing work-life demands is made more difficult due to the culturally rewarded norms of medical education and practice and learning cultures that often view articulated balance as a sign of weakness. As trainees, many clinicians ignore their own physical and emotional well-being and then carry these habits into their career. This makes it enormously difficult for clinicians to recognize and acknowledge when they are burning out or burnt out and to seek help when needed. Significantly, stigma and fear of personal/professional ramifications may also inhibit individuals from seeking help. Leaders, peers, and peer counselors can help foster joy in practice and a culture of wellness by:
- Recognizing the importance of quality, ergonometric attention and of higher, qualified staff ratios for optimal patient/professional care settings
- Improving operational and clinical efficiency
- Optimizing the electronic health record and leveraging decision support tools
- Supporting models of team-based care
- Providing channels for input into decision-making
- Building a sense of community in which clinicians feel supported, appreciated, and accepting of constructive feedback
Learn more on how leadership can support solutions that improve clinician well-being.
Career Fit/Career Stage
Midcareer physicians may be at higher risk for burnout than late or early career individuals due to more work hours, taking more night calls, work-home conflicts, lower work-life balance, and greater career dissatisfaction. Some research suggests that individuals who choose to become physicians are not inherently more vulnerable to stress and burnout but, rather, training processes and the learning/practice environment inhibit well-being and contribute to the deterioration of mental health. Physicians who spend less than 20% of their work effort on an activity they find most personally meaningful are 275% more likely to experience burnout. Clerical tasks leave clinicians with less time to focus on activities they find most meaningful, like caring for patients. Other demographics and psycho-social factors may affect how career stage and job satisfaction contribute to burnout differently among clinicians from across specialties, but more research is needed. More research is also needed to understand how these factors may affect nurses, pharmacists, dentists, and other health care professionals.
Demographic Profiles of Those at Higher Risk for Burnout
While organizations must invest in programs that support well-being for all clinicians, some studies show that younger physicians may be at increased odds for burnout compared to those who are older than 55. This may be a result of higher educational debt, longer work hours, more night shifts, clerical burdens, and work-home conflict. Among helping professionals, the prevalence of burnout is shown to be lower in African Americans than Caucasians, although race does seem to contribute to the distress that minority trainees experience. One study found that minority medical students are more likely to report lower quality of life than nonminority students. Additional studies are needed to more fully understand how race and ethnicity may affect the experiences of minority clinicians to ensure that targeted solutions improve the learning and practice environment for all. Mentorship and coaching programs involving seasoned clinicians with similar or shared experiences may be helpful.
Additionally, some studies have found that female physicians have a 30-60% increased odds of burnout and that female physicians are more likely to experience depressive symptoms than male physicians. Women may find themselves juggling the responsibilities of professional life with the additional roles they play in their personal lives more than men do. For example, in a study of married physicians with children, men reported that 82% of “all or most” household duties were performed by their spouses as opposed to only 5% of women physicians. After accounting for age, experience, faculty rank, and measures of research productivity, female physicians are also shown to have lower salaries than their male counterparts. These data may not generalize to other fields, like pharmacy and dentistry, and more research is needed to accurately and fully understand how gender differences may or may not impact the risk of burnout in all clinicians.
Relationships and Social Support
Some research shows that work-home conflict can increase risk of clinician burnout by 200-250%. Time spent at home on work-related tasks also results in a 2% increased chance for burnout for each additional hour per week. Having a child younger than 21 years old increased burnout by 54% and work-family conflict has been shown to lead to higher levels of emotional exhaustion in nurses. Similar results are seen in physicians. Organizations must work to build environments in which clinicians have time to attend to their personal lives without professional consequences. Clinicians are humans too and have families they must care for and support. Imbalanced work-life integration is a common predictor for burnout and social support is necessary for both clinicians and trainees. Daily breaks, mentoring systems, and organizational awareness of the risks for burnout have been shown to improve well-being in physicians. Increasing resources to facilitate the growth of practitioners and administrative staff within a hospital or clinical practice setting can also help ease the burden of clerical duties and give practitioners more time for small breaks and to attend to patients.
At work, a sense of community and belonging is critical for clinicians to feel surrounded by appreciation, support, and compassion. Leaders are well-positioned to help foster a sense of community and support by encouraging clinicians to extend compassion to their colleagues as they would to patients. Leaders must model and reinforce an environment that allows for self-care and gives permission for self-care and good patient care to coexist. Leaders, peers, and peer counselors can help build a culture in which self-care is a core competency and where self-care and patient care are not viewed as competing interests. Clinician burnout may impede patient safety so it is in the interest of leadership to understand how burnout affects their organization, to engage in ongoing dialogue with staff about burnout, and to commit to developing and implementing targeted solutions so their staff and patients can thrive.
Resources on Personal Factors
A Journey to Construct an All-Encompassing Conceptual Model of Factors Affecting Clinician Well-Being and Resilience
Why are so many clinicians experiencing burnout? The answer is complex but this discussion paper from the National Academy of Medicine aims to shed light on the issues contributing to of clinician burnout and...
Family dynamics, work-life integration, and amount of social support are contributors to how and when clinicians experience burnout. Organizations must work to ensure that clinicians feel supported, appreciated, and able to seek help when needed.
Financial stressors (student loans, unpaid debts, insurance), life changes (relocation, new child, divorce, death of a loved one), personal values, ethics, morals, sense of meaning, and level of engagement/connection to work may also contribute to burnout. View a conceptual model from the Action Collaborative on Clinician Well-Being and Resilience to view more individual factors that may affect clinician burnout and well-being.
Both organizational and individual strategies must be implemented to foster clinician well-being. These strategies must work to change working environments so clinicians feel supported and appreciated and must provide room for clinicians to seek help when needed. Personal factors, like distress from inadequate work-life integration, affect if and when a clinician experiences phases of burnout. An informed understanding of the various factors that can lead to clinician burnout can be used by organizations to help tailor effective programs that promote well-being for all their employees.