Occupational Characteristics Associated with Professional Fulfillment and Burnout Among U.S. Physiatrists

• Published in: PM & R Vol. 15; no. 5; pp. 541 - 551
• Main Authors: Makowski, Maryam S., Trockel, Mickey, Paganoni, Sabrina, Weinstein, Stuart, Verduzco‐Gutierrez, Monica, Kinney, Carolyn, Kennedy, David J., Sliwa, James, Wang, Hanhan, Knowlton, Tiffany, Stautzenbach, Tom, Shanafelt, Tait D.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-05-2023
• Subjects: Burnout, Professional - epidemiology; Female; Humans; Male; Middle Aged; Personal Satisfaction; Physiatrists; Physicians; Surveys and Questionnaires
• ISSN: 1934-1482; 1934-1563
• DOI: 10.1002/pmrj.12961

Introduction
Multiple national studies suggest that, among physicians, physiatrists are at increased risk for occupational burnout.
Objective
To identify characteristics of the work environment associated with professional fulfillment and burnout among U.S. physiatrists.
Design
Between May and December 2021, a mixed qualitative and quantitative approach was used to identify factors contributing to professional fulfillment and burnout in physiatrists.
Setting
Online interviews, focus groups, and survey.
Participants
Physiatrists in the AAPM&R Membership Masterfile.
Main Outcome Measures
Burnout and professional fulfillment assessed using the Stanford Professional Fulfillment Index.
Results
Individual interviews with 21 physiatrists were conducted to identify domains that contributed to professional fulfillment followed by focus groups for further definition. Based on themes identified, scales were identified or developed to evaluate: control over schedule (6 items; Cronbach's alpha = 0.86); integration of physiatry into patient care (3 items; Cronbach's alpha = 0.71); personal‐organizational values alignment (3 items; Cronbach's alpha = 0.90); meaningfulness of physiatrist clinical work (6 items; Cronbach's alpha = 0.90); teamwork and collaboration (3 items; Cronbach's alpha = 0.89). Of 5760 physiatrists contacted in the subsequent national survey, 882 (15.4%) returned surveys (median age 52 years; 46.1% women). Overall, 42.6% (336 of 788) experienced burnout and 30.6% (244 of 798) had high levels of professional fulfillment. In multivariable analysis, each one‐point improvement in control over schedule (odds ratio [OR] = 1.96; 95% confidence interval [CI] = 1.45–2.69), integration of physiatry into patient care (OR = 1.77; 95% CI = 1.32–2.38), personal‐organizational values alignment (OR = 1.92; 95% CI = 1.48–2.52), meaningfulness of physiatrist clinical work (OR = 2.79; 95% CI = 1.71–4.71) and teamwork and collaboration score (OR = 2.11; 95% CI = 1.48–3.03) was independently associated with higher likelihood of professional fulfillment.
Conclusions
Control over schedule, optimal integration of physiatry into clinical care, personal‐organizational values alignment, teamwork, and meaningfulness of physiatrist clinical work are strong and independent drivers of occupational well‐being in U.S. physiatrists. Variation in these domains by practice setting and subspecialty suggests tailored approaches are needed to promote professional fulfillment and reduce burnout among U.S. physiatrists.