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- Title
Well-Being Parameters and Intention to Leave Current Institution Among Academic Physicians.
- Authors
Ligibel, Jennifer A.; Goularte, Nicolette; Berliner, Jennifer I.; Bird, Steven B.; Brazeau, Chantal M. L. R.; Rowe, Susannah G.; Stewart, Miriam T.; Trockel, Mickey T.
- Abstract
Key Points: Question: What proportion of academic physicians intend to leave their current institution within the next 2 years, and what factors are associated with intention to leave? Findings: In this cross-sectional study of 18 719 academic physicians, approximately one-third reported moderate or greater intention to leave. Burnout, lack of professional fulfillment, and other personal and organizational factors were associated with intention to leave. Meaning: In this study, intention to leave was prevalent in academic physicians and was associated with numerous well-being factors; a comprehensive approach will be needed to reduce physician turnover. This cross-sectional study describes the prevalence of burnout, professional fulfillment, and intention to leave among physicians at academic-affiliated health care systems and identifies institutional and individual factors associated with intention to leave. Importance: Physician turnover interrupts care delivery and creates health care system financial burden. Objective: To describe the prevalence of burnout, professional fulfillment, and intention to leave (ITL) among physicians at academic-affiliated health care systems and identify institutional and individual factors associated with ITL. Design, Setting, and Participants: This cross-sectional study administered a survey to 37 511 attending-level medical specialists at 15 academic medical institutions participating in the Healthcare Professional Well-Being Academic Consortium. Data were collected from October 2019 to July 2021. Statistical analysis was performed from May 2022 to March 2023. Exposures: Hypothesized institutional and individual determinants of occupational well-being. Main Outcomes and Measures: The main outcome was ITL, defined as having at least a moderate intention (a score of 2 on a 0-4 scale) to leave one's institution within the next 2 years. Additional outcomes included burnout and professional fulfillment, defined using published Professional Fulfillment Index cut points. Results: Of 18 719 academic physician survey respondents (8381 [44.8%] male; 2388 [12.8%] Asian, 10 599 [56.6%] White, 1039 [5.6%] other race, 4693 [25.1%] unknown race; 294 [1.6%] Hispanic or Latina/Latino/Latinx), 6903 of 18 217 (37.9%) met criteria for burnout and 7301 of 18 571 (39.3%) for professional fulfillment; 5177 of 15 890 (32.6%) reported moderate or greater ITL. Burnout, professional fulfillment, and ITL varied across specialties. After adjusting for demographics, each 1-point increase (range 0-10) in burnout was directly associated with ITL (odds ratio [OR], 1.52 [95% CI, 1.49-1.55])c, and each 1-point increase in professional fulfillment was inversely associated with ITL (OR, 0.64 [95% CI, 0.63-0.65]). After adjusting for demographics, burnout, and professional fulfillment, each 1-point increase (range 0-10) in supportive leadership behaviors (OR, 0.83 [95% CI, 0.82-0.84]), peer support (OR, 0.93 [95% CI, 0.91-0.95]), personal-organizational values alignment (OR, 0.81 [95% CI, 0.80-0.82]), perceived gratitude (OR, 0.95 [95% CI, 0.92-0.97]), COVID-19 organizational support (OR, 0.88 [95% CI, 0.85-0.91]), and electronic health record helpfulness (OR, 0.95 [95% CI, 0.93-0.97]) were inversely associated with ITL, whereas each 1-point increase (range 0-10) in depression (OR, 1.08 [95% CI, 1.05-1.10]) and negative impact of work on personal relationships (OR, 1.09 [1.07-1.11]) were directly associated with ITL. Conclusions and Relevance: In this cross-sectional study of academic physicians, 32.6% indicated moderate or higher ITL within 2 years. Burnout, lack of professional fulfillment, and other well-being factors were associated with ITL, suggesting the need for a comprehensive approach to reduce physician turnover.
- Subjects
PSYCHOLOGICAL burnout; WELL-being; STATISTICS; RACISM; ACADEMIC medical centers; CONFIDENCE intervals; CROSS-sectional method; LEADERSHIP; LABOR turnover; SURVEYS; JOB satisfaction; MENTAL depression; INTERPERSONAL relations; INTENTION; DATA analysis; ODDS ratio; ELECTRONIC health records; PSYCHOLOGY of physicians
- Publication
JAMA Network Open, 2023, Vol 6, Issue 12, pe2347894
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2023.47894