Self-Valuation Challenges in the Culture and Practice of Medicine and Physician Well-being |
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| Affiliation: | 1. Stanford University School of Medicine, Palo Alto, CA;2. American Medical Association, Chicago, IL;3. Mayo Clinic, Rochester, MN;1. Director of the Program on Physician Well-being, Mayo Clinic, Rochester, MN;2. President and Chief Executive Officer, Mayo Clinic, Rochester, MN;1. Divisions of Allergy, Immunology and Rheumatology and Pediatric Allergy and Immunoloy, University of Rochester, Rochester, New York;2. Division of Allergy/Immunology, Department of Pediatrics, University of California San Diego, San Diego, California;1. American Medical Association, Chicago, IL;2. Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN;3. Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN;4. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN;5. Division of Hematology, Mayo Clinic, Rochester, MN;1. Stanford Medicine, Stanford, CA;2. The Risk Authority, Columbia, SC;3. Stanford University School of Medicine, Stanford, CA;4. Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN;5. Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN;6. Quality Safety and Risk Prevention, Vanderbilt University Medical Center, Nashville, TN;7. Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, TN |
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| Abstract: | ObjectiveTo compare physicians with workers in other fields on measures of self-valuation (SV) and determine the effect of adjusting for SV on the relationship between being a physician and risk for burnout.Patients and MethodsA random sample of physicians from the American Medical Association Physician Masterfile and a probability sample from the general US population were used. Data were collected for this cross-sectional study between October 12, 2017 and March 15, 2018. Burnout was indicated by a score of 27 or higher on Emotional Exhaustion or 10 or higher on Depersonalization, using the Maslach Burnout Inventory. Self-valuation was measured with Self-valuation Scale items.ResultsPhysicians (248/832=29.8%) more than workers in other fields (1036/5182=20.0%) “often” or “always” felt more self-condemnation than self-encouragement to learn from the experience when they made a mistake. Physicians (435/832=52.3%) more than workers in other fields (771/5182=14.9%) “often” or “always” put off taking care of their own health due to time pressure. Physicians had greater odds of burnout before (odds ratio [OR], 1.51; 95% CI, 1.30 to 1.76) but not after adjusting for SV responses (OR, 0.93; 95% CI, 0.78 to 1.11). After adjustment for SV, work hours, sex, and age, physicians had lower odds of burnout than workers in other fields (OR, 0.82; 95% CI, 0.68 to 0.99).ConclusionSelf-valuation is lower in physicians compared with workers in other fields and adjusting for SV eliminated the association between being a physician and higher risk for burnout. Experimental design research is needed to determine whether the association of SV with burnout is causal and the degree to which SV is malleable to intervention at individual, organization, and professional culture levels. |
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