Burnout Rates High Among Emergency Physicians in the Caribbean

Lynn-Marie P. Lovell, MBBS

Burnout and resiliency remain an issue for doctors in emergency departments that both increases of negative outcomes for the physician and puts the patient at risk due to medical errors.

A team, led by Lynn-Marie P. Lovell, MBBS, Emergency Medicine, Queen Elizabeth Hospital; Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, explored burnout and resiliency among physicians working in emergency departments in Caribbean.

Burnout

Burnout is a common issue in emergency departments, particularly during the COVID-19 pandemic. Even prior to the pandemic, physicians were 15 times more likely than other professionals to suffer from burnout, largely due to emotional exhaustion, depersonalization, and reduced personal accomplishments.

Burnout can lead to a number of negative outcomes, including increased coronary artery disease, peptic ulcer disease, drug abuse, and sleep disturbances, as well as mental effects such as post-traumatic stress disorder and higher rates of suicidal ideation. There are also added risks to patients being treated by a burnout doctor who is at an increased risk of error.

“Importantly, physicians in emergency medicine have higher burnout and lower average personal accomplishment compared to other specialties,” the authors wrote. “A physician's capability to ‘bounce back’ is essential and this is the hallmark of resilience.”

However, very few studies on looked specifically at emergency physicians.

Surveys

In the study, the investigators collected from 111 patients using the Maslach Burnout Inventory (MBI) and the Resilience Scale-14 (RS14) as measures of burnout and resilience, respectively. The investigators collected data on participant demographics and characteristics related to self-care and explored the associations between demographic characteristics and total burnout and resilience scale.

The results show 88.6% of participants had medium to high range emotion exhaustion, while 82.8% exhibited medium to high range depersonalization and 19.6% of patients had low to medium range personal accomplishment.

For participants in Barbados, there was a higher emotional exhaustion and depersonalization scores found (P = 0.009), while individuals in a postgraduate program had higher depersonalization scores (P = 0.047). The mean RS-14 score was 81,1 out of a maximum of 98.0 with a standard deviation of 13.1 and a range of 26-98.

In addition, depression was associated with high emotional exhaustion scores (P = 0.004) and low resilience scores (P <0.0001), while emotional exhaustion scores increased in individuals using alcohol daily (P = 0.01), using recreational drugs (P = 0.021), and sleeping aids (P = 0.028).

“High burnout, despite high resilience, is present in this sample of physicians working in emergency departments of teaching hospitals in the Caribbean,” the authors wrote. “Although resilience scores were high, those with lower resilience tendencies had poorer self-care habits.”

The study, “An exploration of burnout and resilience among emergency physicians at three teaching hospitals in the English-speaking Caribbean: A cross-sectional survey,” was published online in The Lancet Regional Health- Americas.