Burnout rate lower than believed, but still too high

A new look at the burnout rate among practicing urologists shows that the problem may not be as widespread as previously reported. Nevertheless, nearly 40% of urologists are burned out, a number researchers say is still much too high.

Boston-A new look at the burnout rate among practicing urologists shows that the problem may not be as widespread as previously reported. Nevertheless, nearly 40% of urologists are burned out, a number researchers say is still much too high.

Burnout is increasingly concerning in medicine, and has been associated with depression, interpersonal conflict, and medical errors. In urology in particular, it may contribute to a looming work force shortage.

The new study, based on results from the 2016 AUA Census, follows up on two published studies by Mayo Clinic researchers examining burnout rates across multiple specialties. In a 2011 study (Arch Intern Med 2012; 172:1377-85), the Mayo team reported that 41.2% of urologists were burned out, similar to the average across all specialties. That number jumped to 63.6% in a subsequent 2014 study (Mayo Clin Proc 2015; 90:1600-13), giving urologists the distinction of being the most burned out of all the specialists studied.

Dr. North“Urologists think we have a pretty good job, so when we found out that we were the most burned out of any specialist, we got very concerned,” said Amanda C. North, MD, assistant professor of urology at Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY. She presented the most recent study data at the AUA annual meeting in Boston.

In their study, Dr. North and colleagues from the AUA and multiple institutions included the Maslach Burnout Inventory, a standard tool used in burnout research, in the 2016 AUA Census questions. They focused on two components of the Maslach tool-emotional exhaustion and depersonalization-that were the same two components examined by the Mayo Clinic team.

The overall burnout rate for practicing urologists was 38.8%, Dr. North reported. Some 37% scored high for depersonalization and 17% scored high for emotional exhaustion, percentages that are comparable with other medical and surgical specialties.

Next: Sampling bias in earlier study

Sampling bias in earlier study

“When we looked at the age group that was shown in the Mayo Clinic data-ages 29 to 65-the burnout rate went up to 41.3%,” which was similar to the Mayo group’s 2011 figure, Dr. North said. “So we think there must have been a sampling bias in the 2014 data.”

The AUA Census study represents 2,300 urologists, whereas the 2014 Mayo study was based on a sample of 119 urologists.

Study results showed no difference in burnout rates by practitioner gender or race. However, certain factors, including practice type, subspecialty area, and age groups were associated with burnout. On multivariate analysis, burnout factors included greater number of patient visits in a typical week, younger physician age group, practicing in a subspecialty other than pediatric urology or oncology, in either a solo or multispecialty setting, practice size of more than two, and greater number of work hours in a typical week.

“We’re still saying that two out of every five urologists is burned out. Obviously, that’s too high a number,” Dr. North said. “One of our concerns is that urologists are projected to have among the worst work force shortages in the future. We know that burned-out doctors tend to stop practicing. So we really need to work hard to improve our burnout rate, even though it is lower than previously reported.”