Higher Resilience Linked to Lower Burnout Rates for Physicians

Colin P. West, Md, PhD

Having a high level of resilience reduces the chance a physician will suffer from burnout, according to a new survey.

A team, led by Colin P. West, MD, PhD, Division of General Internal Medicine, Department of Medicine, Mayo Clinic, examined how resilient physicians are compared to the remainder of the US workforce and whether there is a link between resilience and burnout among physicians.

While the prevalence of physician burnout is well known, 1 option to reduce this burden discussed in recent years is resilience training.

The cross-sectional survey study included 5445 respondents from 30,456 physicians, as well as a probability-based sample of 5198 individuals in the US workforce. The median age of physician respondents was 53 years old.

The investigators also conducted a secondary survey with intensive follow-up in a random sample of 500 physicians who did not respond to the original electronic survey to evaluate for response bias.

The investigators measured resilience using the 2-item Connor-Davidson Resilience Scale (total scores range from 0-8; higher scores indicate greater resilience).

They also measured burnout using the Full Maslach Burnout Inventory with overall burnout indicated by a score of at least 27 on the 0-54 emotional exhaustion subscale and/or at least 10 on the depersonalization subscale (higher scores indicate greater burnout).

The investigators discovered significantly higher resilience scores among physicians than the general employed US population, which were associated with lower burnout rates. However, even the most resilient physicians did have substantial rates of burnout.

Using a multivariable analysis, the mean resilience scores were higher among physicians than it was for the general workforce (6.49 [1.30] vs 6.25 [1.37]; adjusted mean difference, 0.25 points; 95% CI, 0.19-0.32; P&thinsp;<&thinsp;.001).

The team also found physicians without overall burnout had higher mean resilience scores than the doctors with burnout (6.82 [1.15] vs 6.13 [1.36]; adjusted mean difference, 0.68 points, 95% CI, 0.61-0.76; P&thinsp;<&thinsp;.001).

Each 1-point increase in resilience score was linked to a 36% decrease in the odds of overall burnout (OR, 0.64; 95% CI, 0.60-0.67; P <0.001).

However, 392 of 1350 physicians (29%) with the highest possible resilience score had burnout.

“The findings suggest that, although maintaining and strengthening resilience is important, physicians overall do not have a deficit in resilience; additional solutions, including efforts to address system issues in the clinical care environment, are needed to reduce burnout and promote physician well-being,” the authors wrote. “Additional solutions, including efforts to address system issues in the clinical care environment, are needed to reduce burnout and promote physician well-being.”

National data suggests approximately 44% of US physicians experience symptoms of burnout, which is characterized by emotional exhaustion and/or depersonalization, at least weekly.

Overall, the physicians were more likely to be male, younger, and married and reported working longer hours.

Physician burnout is known to have major consequences on patient health as well. A 2018 meta-analysis found physicians with burnout are twice as likely to be involved in patient safety incidents, twice as likely to deliver suboptimal care to patients owing to low professionalism, and 3 times more likely to receive low satisfaction ratings from patients.

The study, “Resilience and Burnout Among Physicians and the General US Working Population,” was published online in JAMA Psychiatry.