Qualitative study of burnout, career satisfaction, and well-being among US neurologists in 2016
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Abstract
Objective: To understand the experience and identify drivers and mitigating factors of burnout and well-being among US neurologists.
Methods: Inductive data analysis was applied to free text comments (n = 676) from the 2016 American Academy of Neurology survey of burnout, career satisfaction, and well-being.
Results: Respondents providing comments were significantly more likely to be older, owners/partners of their practice, solo practitioners, and compensated by production than those not commenting. The 4 identified themes were (1) policies and people affecting neurologists (government and insurance mandates, remuneration, recertification, leadership); (2) workload and work–life balance (workload, electronic health record [EHR], work–life balance); (3) engagement, professionalism, work domains specific to neurology; and (4) solutions (systemic and individual), advocacy, other. Neurologists mentioned workload > professional identity > time spent on insurance and government mandates when describing burnout. Neurologists' patient and clerical workload increased work hours or work brought home, resulting in poor work–life balance. EHR and expectations of high patient volumes by administrators impeded quality of patient care. As a result, many neurologists reduced work hours and call provision and considered early retirement.
Conclusions: Our results further characterize burnout among US neurologists through respondents' own voices. They clarify the meaning respondents attributed to ambiguous survey questions and highlight the barriers neurologists must overcome to practice their chosen specialty, including multiple regulatory hassles and increased work hours. Erosion of professionalism by external factors was a common issue. Our findings can provide strategic direction for advocacy and programs to prevent and mitigate neurologist burnout and promote well-being and engagement.
GLOSSARY
- AAN=
- American Academy of Neurology;
- ABPN=
- American Board of Psychiatry and Neurology;
- CMS=
- Centers for Medicare and Medicaid Services;
- EHR=
- electronic health record;
- MOC=
- Maintenance of Certification
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
Editorial, page 1658
- Received April 24, 2017.
- Accepted in final form July 10, 2017.
- © 2017 American Academy of Neurology
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Letters: Rapid online correspondence
- Author response to Dr. Sethi
- Janis M. Miyasaki, Professor, University of Albertamiyasaki@ualberta.ca
- Carol Rheame, Lisa Gulya, Minneapolis, MN; Aviva Ellenstein, Washington, DC; Heidi Schwarz, Rochester, NY; Thomas Vidic, Elkhart, Indiana; Tait Shanafelt, Terrence Cascino, Rochester, MN; Chris Keran, Minneapolis, MN; Neil Busis, Pittsburgh, PA
Submitted November 08, 2017 - Burnout in neurology: Learning to roll with the punches
- Nitin K. Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Centersethinitinmd@hotmail.com
Submitted November 01, 2017
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