An exploration of the role of religion/spirituality in the promotion of physicians' wellbeing in Emergency Medicine

Abstract

Background: Burnout is highly prevalent among Emergency Medicine (EM) physicians and has significant impact on quality of care and workforce retention. The objective of this study was to determine whether higher religion/spirituality (R/S) is associated with a lower prevalence of burnout among EM physicians (primary outcome). A history of malpractice lawsuits and maladaptive behaviors were the secondary outcomes.

Methods: This was a cross-sectional, survey-based study conducted among a random sample of physicians from the Massachusetts College of Emergency Physicians mailing list. Burnout was measured using a validated 2-item version of the Maslach Burnout Inventory. Maladaptive behaviors (smoking, drinking, and substance use) and medical malpractice were self-reported. R/S measures included organized religiosity, religious affiliation, private R/S practice, self-rated spirituality, religious rest, and religious commitment. Logistic regression was used to model study outcomes as a function of R/S predictors.

Results: Of 422 EM physicians who received the invitation to participate, 138 completed the survey (32.7%). The prevalence of burnout was 27%. No significant associations were observed between burnout and R/S indicators. Maladaptive behaviors (adjusted OR = 0.42, CI: 0.19 to 0.96; p = 0.039) and history of medical malpractice (adjusted OR = 0.32; CI: 0.11 to 0.93; p = 0.037) were less likely among physicians reporting to be more involved in organized religious activity and to observe a day of rest for religious reasons, respectively.

Conclusion: This study provides preliminary evidence for a possible protective association of certain dimensions of R/S on maladaptive behaviors and medical malpractice among EM physicians.

Keywords: Burnout; Emergency medicine; Prevention; Religion; Spirituality.

Fig. 1

a. Odds of burnout by R/S characteristics. Adjusted for marital status, number of children, number of hours on call/week, and number of hours directly involved in patient care/week. b. Odds of previous medical malpractice lawsuit by R/S characteristics. Adjusted for smoking, type of institution, and years in EM. Self-rated spirituality: very vs. non-spiritual. c. Odds of maladaptive behaviors (smoking, alcohol and substance use) by R/S characteristics. Adjusted for gender, number of children, and years in EM. Self-rated spirituality: very vs. non-spiritual. For all figures, variables are categorized as: Organized religiosity: ever vs. never; Religious affiliation: any vs. none; Private prayer: ever vs. never; meditation: never vs. never; Self-rated spirituality: very vs. non-spiritual; religious rest: ever vs. never; religious commitment: agree/somewhat vs. disagree/somewhat disagree.