Pandemic-related factors predicting physician burnout beyond established organizational factors: cross-sectional results from the COPING survey

ABSTRACT

The COVID-19 pandemic has increased physician burnout beyond high baseline levels. We aimed to determine whether pandemic-related factors contribute to physician burnout beyond known organizational factors. This was a cross-sectional survey of Canadian physicians using a convenience sample. Eligible participants included any physician currently holding a license to practice in Canada. Responses were gathered from May 13 to 12 June 2020. Risk factors measured included the newly developed Pandemic Experiences and Perceptions Scale (PEPS) subscales, contact with virus, pandemic preparation, and provincial caseload. The primary outcome was the Maslach Burnout Inventory (MBI). The primary outcome was completed by 309 respondents. Latent profile analysis found 107 (34.6%) respondents were burned out. In multivariate analysis, exhaustion was independently associated with PEPS adequacy, risk perception, and worklife subscales (adjusted R² = 0.236, P < 0.001). Cynicism was associated with exhaustion, and PEPS worklife (adjusted R² = 0.543, P < 0.001). Efficacy was associated with cynicism, PEPS worklife, and active cases (adjusted R² = 0.152, P < 0.001). Structural equation modelling showed statistically significant direct paths between PEPS areas of worklife and all MBI subscales. Contact with virus, preparation, and PEPS risk perception added to the prediction of MBI exhaustion. Among a sample of Canadian physicians during the COVID-19 pandemic, adequacy of resources, risk perception, and quality of worklife were associated with burnout indices. To mitigate physician burnout organizations should work to improve working conditions, ensure adequate resources, and foster perceived control of risk of transmission.

Trial Registration: NCT04379063.

KEYWORDS:

• Burnout
• physician mental health
• pandemic
• COVID-19
• wellness
• occupational health

Disclosure statement

Michael Leiter receives royalty payments for the Maslach Burnout Inventory General Scale from Mindgarden Publishing. All fees were waived for this project. Other authors have no conflicts of interest.

Author contributions

Bailey JG, conceptualization, protocol development, survey distribution, data analysis, drafting manuscript, gave final manuscript approval.

Wong M, protocol development, survey distribution, manuscript revisions, gave final manuscript approval.

Bailey K, conceptualization, data analysis, manuscript revisions, gave final manuscript approval.

Banfield J, conceptualization, data acquisition, administrative support, manuscript revisions, gave final manuscript approval.

Barry G, drafting and revision of manuscript, gave final manuscript approval.

Munro A, drafting and revision of manuscript, gave final manuscript approval.

Kirkland S, protocol development, manuscript revisions, gave final manuscript approval.

Leiter M. measure development, data analysis, drafting manuscript sections, gave final manuscript approval.

Data availability statement

Results from this paper are generated from data that are part of a larger longitudinal dataset. Further publications are planned but further information regarding the dataset can be requested by contacting the corresponding author.

Additional information

Funding

This research was supported by the Dalhousie Department of Anesthesia, Pain Management & Perioperative Medicine.