Rx for physician burnout: High-quality supervisors

A good boss may make the difference between a resilient and satisfied physician and a burned-out and disgruntled one, according to a study published in the April issue of the Mayo Clinic Proceedings. The higher doctors scored their supervisors, the less likely they were to report burnout or dissatisfaction.

“The deep understanding of medical practice requisite to leading and guiding the professional development of physicians often necessitates that the leaders themselves be physicians,” observed Tait D. Shanafelt, MD, of the Office of Leadership and Organization Development at the Mayo Clinic in Rochester, Minn., and colleagues. “Physician leaders are, however, typically selected based on their clinical acumen, scientific expertise, or reputation rather than on the qualities necessary to be an effective leader.”

With many physicians now working in an employed model, the researchers wanted to explore the relationship between the leadership qualities of physician supervisors and physicians’ perceived well-being and burnout. To do so, they used a survey that is sent to the Mayo Clinic Health System staff every two years that includes anonymous evaluations of immediate supervisors.

They focused on two measures in the Maslach Burnout Inventory for burnout: emotional exhaustion and depersonalization. The leadership quality portion listed 12 items, with the last question asking respondents to rate their overall satisfaction.

Their results were based on the October 2013 survey. All of the supervisors were physicians or scientists.

They surveyed 3,896 physicians across the system, with a 72.2 percent response rate. Almost all respondents were directly engaged in patient care and half had been in practice for more than a decade. More than one-third reported a high level of emotional exhaustion and 15 percent reported high depersonalization.

Most (79 percent) were satisfied or very satisfied with the organization while 9 percent were dissatisfied or very dissatisfied.

After adjusting for age, sex, duration at Mayo and specialty, they determined that every one point increase in the composite leadership score translated into a 3.3 percent drop in the likelihood of burnout and a 9 percent increase in the likelihood of satisfaction. The mean composite leadership rating had a significant relationship with the burnout rate at the department level, as did mean leadership score and satisfaction rates.

“At the work unit level, 11% of the variation in burnout and 47% of the variation in satisfaction with the organization was explained by the leadership rating of the division/department chairperson,” they wrote. “This is remarkable when one considers the extent of other factors that influence satisfaction (eg, salary, workload expectations, speciality, culture, strategic direction of the organization, personality conflicts, and opportunities for professional development).”

They detected no relationship between a supervisor’s level of burnout and the prevalence of burnout in the department while the leader’s satisfaction had a small correlation with satisfaction by the work unit.