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Burnout among trainee pediatricians leads to worse patient care
February 23, 2017 / 7:31 PM / 7 months ago

Burnout among trainee pediatricians leads to worse patient care

(Reuters Health) - A large number of pediatricians in training may already be experiencing burnout, a recent U.S. study suggests, and those who do are more likely to make errors or take shortcuts during treatment.

New doctors, known as residents, tend to work extremely long hours and are at high risk for job burnout, the study team writes in the journal Pediatrics.

“Burnout is common, and it has the potential to impact patient care,” said lead author Dr. Tamara Baer, a pediatric physician at Boston Children’s Hospital in Massachusetts. “As pediatricians, quality patient care is always our top priority. However, to take good care of patients, physicians also need to remain healthy and motivated.”

Irregular work hours, sleep deprivation and limited leisure time may place residents at particularly high risk for burnout, and as many as three in four residents report feeling burned out in their jobs, the research team writes.

To explore the link between burnout and the attitudes of pediatric resident toward patients, Baer’s team conducted a web survey of 258 residents from 11 pediatric residency programs in New England.

The majority of residents who responded were white women between the ages of 26 and 29, married or in a significant relationship, and didn’t have children.

All participants answered questions designed to measure burnout, such as whether they felt more callous toward people since starting their job and whether they felt burned out by work.

They also answered seven questions assessing their care of and attitudes toward patients. For each item, the resident had to say whether and how often they experienced things like making medication errors that were not a result of lack of knowledge, not showing sympathy for the social or personal impact of an illness on a patient, or discharging a patient to ease their own workload.

Overall, 39 percent of the residents reported experiencing burnout, with sleep-deprived residents and those over age 30 most likely to feel burned out.

Burned out residents were seven times more likely to make treatment or medication errors that were not due to inexperience or lack of knowledge, compared with residents who were not burned out.

Residents reporting burnout were 3.5 times more likely not to fully discuss treatment options or answer a patient’s questions and four times more likely to discharge a patient to make the service more manageable.

Residents feeling burned out were nearly 10 times more likely to pay little attention to the social or personal impact of an illness on the patient, compared with residents not reporting burnout. And burned out residents were six times more likely to feel guilty about how they had treated a patient.

The mental wellbeing of young doctors has a profound effect on their ability to provide good care and thrive in medical systems, said Dr. John Mahan, a professor of pediatrics at The Ohio State University College of Medicine in Columbus who wrote an editorial accompanying the study.

“If we do not address these issues of stress, compassion fatigue and emotional exhaustion, we will have less effective physicians and poorer health in our population,” Mahan told Reuters Health by email.

Mahan said medical training programs need to help beginning doctors learn resilience-building skills like reflection, positivity and mindfulness.

“The medical profession and medical educators are embracing this imperative - we are aware of the issues and are committed to developing healthy, resilient physicians,” Mahan said.

“It is crucial for the health care system to address burnout among residents - and among all members of health care teams - and to focus on systemic interventions and changes in workplace culture that will mediate the effects of burnout,” Baer said.

SOURCE: bit.ly/2lv98P3 and bit.ly/2lJSSKP Pediatrics, online February 23, 2017.

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