Worklife and Wellness in Academic General Internal Medicine: Results from a National Survey.

ABSTRACT:

Background

General internal medicine (GIM) careers are increasingly viewed as challenging and unsustainable.

Objective

We aimed to assess academic GIM worklife and determine remediable predictors of stress and burnout.

Design

We conducted an email survey.

Participants

Physicians, nurse practitioners, and physician assistants in 15 GIM divisions participated.

Main measures

A ten-item survey queried stress, burnout, and work conditions such as electronic medical record (EMR) challenges. An open-ended question assessed stressors and solutions. Results were categorized into burnout, high stress, high control, chaos, good teamwork, high values alignment, documentation time pressure, and excessive home EMR use. Frequencies were determined for national data, Veterans Affairs (VA) versus civilian populations, and hospitalist versus ambulatory roles. A General Linear Mixed Model (GLMM) evaluated associations with burnout. A formal content analysis was performed for open-ended question responses.

Key results

Of 1235 clinicians sampled, 579 responded (47 %). High stress was present in 67 %, with 38 % burned out (burnout range 10-56 % by division). Half of respondents had low work control, 60 % reported high documentation time pressure, half described too much home EMR time, and most reported very busy or chaotic workplaces. Two-thirds felt aligned with departmental leaders' values, and three-quarters were satisfied with teamwork. Burnout was associated with high stress, low work control, and low values alignment with leaders (all p?ConclusionsWhile GIM divisions overall demonstrate high stress and burnout, division rates vary widely. Sustainability efforts within GIM could focus on visit length, staff support, schedule control, clinic chaos, and EMR stress.

SUBMITTER: Linzer M 

PROVIDER: S-EPMC4978678 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature