Physician burn out linked to patient safety incidents, professionalism concerns, and low patient satisfaction

1. In this meta-analysis of available studies, physician burnout was linked to an increased risk of patient safety incidents, professionalism issues, and reduced patient satisfaction.

2. The quality of studies was low to moderate with high heterogeneity. The reporting method of patient safety incidents and professionalism significantly influenced the results of the primary outcome.

Evidence Rating Level: 2 (Good)

Study Rundown: Physician wellness is a topic of growing concern as efforts to improve health systems and patient care come into focus. Burnout is described as feelings of emotional exhaustion, depersonalization, and reduced professional efficacy. This systematic review examined physician burnout and the association with patient safety incidents, suboptimal care outcomes resulting from poor professionalism, and patient satisfaction. The study found that physician burnout was linked to increased risk of patient safety incidents, low professionalism, and low patient satisfaction. Study heterogeneity was high and evidence quality was graded as low to moderate. Results were influenced by reporting method of outcomes with physician reported outcomes demonstrating greater association than with system-recorded safety issues.

The main strength of this analysis is the large pooled sample size of more than 42000 physicians and careful analysis of consistency across the included studies. The limitations of the analysis stem from the quality of the studies included which were mainly cross-sectional in design, and had variation in methods which influenced the outcomes measured.

Click to read the study in JAMA Internal Medicine

Relevant Reading: Addressing Physician Burnout

In-Depth [systematic review and meta-analysis]: This study consisted of a systematic review of studies including the key words “physicians”, “burnout”, and “patient care”. Any study reporting association between physician burnout and patient safety with quantitative results were included. Qualitative studies and data presented only as conference abstracts were excluded. Primary outcomes were the risk of patient safety incidents, professionalism, and patient satisfaction.

A total of 47 studies were included in the study, encompassing 42 473 physicians. Burnout was linked to an increase risk of patient safety incidents (OR, 1.96; 95%CI, 1.59-

2.40; I2 = 97.7%), low professionalism (OR, 2.31; 95%CI, 1.87-2.85; I2 = 89.5%), and low patient satisfaction (OR, 2.28; 95% CI, 1.42-3.68; I2 = 90.5%). Results were influenced by whether the outcomes were physician reported or systems reported.

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