Physician burnout impacts care (self and patients), productivity, longevity of career, and overall cost. While burnout rates for pediatricians are lower than average (41%), rates have not improved significantly over time. Although strategies at the system level have been more successful than the individual level, both aspects are vital. This QI study explores individual physician wellness and burnout trends of a sample population of pediatricians at the 2018 and 2019 AAP National Conference and Exhibition (NCE) utilizing the Physician Health and Wellness Booth (PHWB). The aim was to improve burnout by 20% over a 6-month period. Of the pediatricians who interacted with the PHWB, fifty-six were randomly selected to participate. The sample included men and women, and spanned from resident physicians to individuals beyond twenty years of practice. Practice settings varied, including academic and non-academic settings. Baseline surveys included a modified Maslach Burnout Inventory, focusing on burnout components (emotional exhaustion, depersonalization and fulfillment) and degree of wellness activities. Individual-based interventions were provided at the PHWB consisting of adult preventative health guidelines, information on sleep, stress mitigation, and complementary medicine. Participants also received a movie ticket and Starbucks gift card. Follow-up included six monthly newsletters with strategies from seven wellness domains. Post-intervention surveys at six months assessed all baseline questions, plus effectiveness of monthly newsletters. A second PDCA cycle was conducted from the 2019 NCE. All individual-based interventions continued, plus an aromatherapy oils sampling station. Additional system based tools were provided including sample institutional wellness initiatives and burnout cost-analyses all focused on empowering advocacy for cultural change at respective organizations. Interactive monthly wellness calendars incorporating seven wellness domains continued for six months follow-up. Post-intervention surveys are pending to date. Results from ten post intervention surveys (10/56 = 18% of respondents) from the initial cohort demonstrated an average of 25% decrease in burnout. This was measured on a scale of 1 to 5 (from “never” burned out to “very often”) and improved from 3.34 (“sometimes” to “often” burned out) to 2.5 (“rarely” to “sometimes” burned out). Participants noted lack of control over work schedules and disconnect with organizational values as drivers of burnout. Both the PHWB and monthly newsletters were rated as valuable as recurrent reminders about wellness practices. Limitations included a low response rate and inability to prove causation of improvement from our intervention. Next steps include assigning subject identification numbers to allow for anonymity while developing a prospective cohort study with a third PDCA cycle. This would allow meaningful comparison of follow-up survey results despite recurrent small sample size. Follow-up incentives could be beneficial. Lastly, data from both cohorts revealed the highest level of burnout in early career physicians within ten years of training, paving an avenue for future study.
Balancing Burnout: Assessing and Improving Physician Health and Wellness
Average Burnout Scores Pre and Post-Wellness Intervention in Cohort 1
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