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. 2023 Dec 1;6(12):e2347894.
doi: 10.1001/jamanetworkopen.2023.47894.

Well-Being Parameters and Intention to Leave Current Institution Among Academic Physicians

Jennifer A Ligibel  1 , Nicolette Goularte  2 , Jennifer I Berliner  3 , Steven B Bird  4 , Chantal M L R Brazeau  5 , Susannah G Rowe  6   7 , Miriam T Stewart  8 , Mickey T Trockel  2
Affiliations

Well-Being Parameters and Intention to Leave Current Institution Among Academic Physicians

Jennifer A Ligibel et al. JAMA Netw Open. .

Abstract

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.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Berliner reported being a voting member of the administrative board and the scientific board for the Healthcare Professional Well-being Academic Consortium. Dr Rowe reported grants from the American Medical Association (grant related to burnout and electronic health record use) outside the submitted work. Dr Trockel reported personal fees from Marvin Behavioral Health Inc (consulting services) outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Intention to Leave (ITL) by Medical Specialty
Figure 2.
Figure 2.. Burnout and Professional Fulfillment by Medical Specialty
See this image and copyright information in PMC

Comment in

References

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