INTRODUCTION
METHODS
Survey Development and Distribution
Study Outcomes and Measures
Statistical Analyses
Qualitative Analysis
RESULTS
Overall Findings
Overall population (N=8141) % | Non-respondents (N=4965) % | Respondents (N=3176) % | Respondents adjusted with response weight % | |
---|---|---|---|---|
Gendera,b | ||||
Female | 44.8 | 40.8 | 51.0 | 44.6 |
Male | 54.9 | 58.8 | 48.8 | 55.1 |
Not available | 0.3 | 0.4 | 0.2 | 0.3 |
Agea | ||||
<35 | 8.3 | 8.9 | 7.4 | 7.6 |
35–54 | 57.6 | 56.8 | 58.8 | 56.3 |
55+ | 33.2 | 33.2 | 33.2 | 35.1 |
Not available | 0.9 | 1.1 | 0.6 | 1.0 |
Role | ||||
Physician | 89.6 | 90.0 | 88.8 | 90.0 |
Non-physician | 10.4 | 10.0 | 11.2 | 10.0 |
Specialtya,b | ||||
Internal Medicine General | 13.2 | 11.7 | 15.6 | 13.4 |
Internal Medicine Subspecialty | 12.1 | 11.5 | 13.2 | 12.2 |
Surgery | 10.4 | 11.1 | 9.3 | 10.4 |
Family Medicine | 9.6 | 7.0 | 13.8 | 9.6 |
Pediatrics | 8.9 | 7.5 | 11.1 | 9.0 |
OB-GYN | 5.2 | 4.6 | 6.2 | 5.2 |
Anesthesiology | 4.9 | 4.4 | 5.6 | 4.9 |
Emergency Medicine | 4.1 | 3.1 | 5.7 | 4.1 |
Radiology | 3.8 | 3.9 | 3.6 | 3.8 |
Urgent care/walk-in care | 3.1 | 2.9 | 3.3 | 3.2 |
Psychiatry | 2.2 | 2.4 | 1.8 | 2.2 |
Ophthalmology | 2.1 | 2.2 | 1.9 | 2.0 |
Dermatology | 1.5 | 1.1 | 2.0 | 1.4 |
Neurology | 1.4 | 1.2 | 1.8 | 1.5 |
Other c | 3.3 | 2.8 | 3.9 | 3.3 |
Not available | 14.2 | 22.6 | 1.2 | 13.8 |
Gender (weighted) | Age (weighted) | Job role (weighted) | |||||||
---|---|---|---|---|---|---|---|---|---|
All clinicians (unweighted) | All clinicians (weighted) | Female | Male | <35 | 35–54 | 55+ | Non-physician | Physician | |
N(%) | % | % | % | % | % | % | % | % | |
Survey questions (selecting “agree”/“strongly agree”) | |||||||||
I feel highly valued. | 2112 (68.4) | 67.9 | 63.7** | 71.5** | 67.5** | 64.5** | 73.8** | 63.7 | 68.4 |
I feel supported and listened to by my leadership. | 2095 (68.1) | 67.8 | 63.0** | 71.6** | 72.4 | 65.2 | 70.6 | 64.9 | 68.1 |
I feel comfortable providing feedback or concerns to my leaders. | 2268 (73.6) | 72.3 | 69.4 | 74.4 | 81.0** | 69.0** | 75.4** | 73.6 | 72.1 |
I believe my concerns will be acted upon. | 1667 (54.1) | 54.6 | 51.0* | 57.6* | 59.1 | 52.4 | 57.3 | 52.8 | 54.8 |
I am worried about my safety at work. | 1302 (42.4) | 43.9 | 45.6 | 42.5 | 38.3 | 45.7 | 42.0 | 35.2* | 44.8* |
My overall well-being has been negatively affected. | 1448 (47.4) | 46.3 | 51.1** | 42.5** | 45.3*** | 50.8*** | 39.5*** | 39.4* | 47.1* |
My childcare or caregiving responsibilities are impacting my work. | 773 (25.3) | 25.2 | 32.9*** | 19.0*** | 16.6*** | 37.5*** | 7.4*** | 22.5 | 25.6 |
I am concerned about loss of income. | 2142 (70.0) | 68.6 | 69.3 | 68.1 | 65.1** | 72.6** | 62.9** | 62.8* | 69.3* |
I am concerned about loss of my job. | 672 (22.0) | 22.3 | 27.2*** | 18.3*** | 39.3*** | 23.7*** | 16.3*** | 47.4*** | 19.4*** |
I feel a great deal of stress because of my job. | 1403 (45.8) | 45.6 | 51.1*** | 41.3*** | 45.8*** | 51.4*** | 36.8*** | 42.7 | 45.9 |
Overall, based on your definition of burnout, how would you rate your level of burnout? (check only one) †‡ | |||||||||
Reporting burnout (checked 3, 4, or 5) | 617 (28.9) | 29.2 | 39.0*** | 22.7*** | 33.4*** | 34.6*** | 21.6*** | 28.8 | 29.3 |
1. I enjoy my work. I have no symptoms of burnout. | 396 (18.5) | 19.4 | 11.7*** | 24.4*** | 15.1*** | 13.8*** | 27.7*** | 17.1 | 19.7 |
2. Occasionally under stress - but I don’t feel burned out… | 1123 (52.6) | 51.4 | 49.3*** | 52.9*** | 51.5*** | 51.6*** | 50.6*** | 54.0 | 51.0 |
3. Definitely burning out… | 465 (21.8) | 20.5 | 30.7*** | 13.6*** | 26.0*** | 22.6*** | 17.1*** | 19.0 | 20.7 |
4. Symptoms of burnout won’t go away… | 112 (5.2) | 5.9 | 6.4*** | 5.6*** | 5.4*** | 8.0*** | 3.2*** | 7.5 | 5.7 |
5. I feel completely burned out and wonder if I can go on… | 40 (1.9) | 2.8 | 1.9*** | 3.5*** | 2.0*** | 4.0*** | 1.4*** | 2.4 | 2.9 |
What can be done to better support you right now? (check all that apply) | |||||||||
More training on COVID-19. | 396 (12.9) | 12.6 | 15.1* | 10.6* | 21.0* | 12.4* | 10.9* | 20.7*** | 11.7*** |
Provide more personal protective equipment (PPE). | 1161 (37.5) | 36.0 | 36.3 | 35.8 | 41.4*** | 39.7*** | 28.6*** | 32.1 | 36.5 |
More training on use of PPE. | 357 (11.6) | 11.4 | 12.0 | 10.9 | 12.2 | 10.8 | 12.4 | 10.8 | 11.5 |
Support for mental health needs. | 410 (13.3) | 12.4 | 15.6** | 9.9** | 17.3 | 13.1 | 10.5 | 17.8** | 11.8** |
Provide more flexibility with schedules. | 839 (27.0) | 25.0 | 29.4*** | 21.6*** | 35.8*** | 28.7*** | 16.8*** | 28.0 | 24.6 |
Other supports. | 490 (16.5) | 15.5 | 16.6 | 14.7 | 10.0** | 14.3** | 18.8** | 13.1 | 15.8 |
How have your professional responsibilities and work changed because of the COVID-19 crisis? (check all that apply) | |||||||||
I have been given additional tasks. | 950 (29.9) | 27.2 | 29.8* | 25.2* | 34.8*** | 30.6*** | 20.8*** | 32.4 | 26.7 |
The hours I work decreased. | 1021 (32.1) | 33.2 | 27.8*** | 37.5*** | 31.3** | 29.4** | 38.8** | 36.1 | 32.9 |
The hours I work increased. | 562 (17.7) | 16.1 | 17.5 | 15.0 | 11.6* | 18.3* | 13.7* | 6.7*** | 17.1*** |
Other changes in work. | 345 (10.9) | 9.3 | 12.6*** | 6.6*** | 11.1 | 8.8 | 9.7 | 12.9 | 8.9 |
No changes in work. | 503 (15.8) | 16.7 | 15.0 | 18.1 | 13.9 | 17.1 | 17.0 | 0.65 | 13.9 |
Factors Associated with Burnout
Model 1
Overall burnout | |
---|---|
Variables† | OR (95% CI) |
Age (reference = age<35)) | |
35–54 | 0.98 (0.66–1.46) |
55+ | 0.54** (0.34–0.87) |
Female | 2.19*** (1.51–3.17) |
Physician (reference = non-physician) | 1.39 (0.92–2.09) |
Specialty (reference = Internal Medicine-General) | |
Anesthesiology | 0.93 (0.57–1.52) |
Dermatology | 1.46 (0.56–3.77) |
Emergency Medicine | 1.58* (1.02–2.43) |
Family Medicine | 1.18 (0.8–1.75) |
Internal Medicine Subspecialty | 1.06 (0.71–1.56) |
Neurology | 1.49 (0.71–3.1) |
OB-GYN | 1.09 (0.69–1.73) |
Ophthalmology | 1.12 (0.49–2.58) |
Pediatrics | 1.09 (0.7–1.68) |
Psychiatry | 1.99' (0.98–4.02) |
Radiology | 1.87* (1.1-3.18) |
Surgery | 0.93 (0.61–1.43) |
Urgent care/express care/walk-in | 0.6 (0.28–1.3) |
Other | 1.78 (0.86–3.7) |
Model 2
Overalla | Age Groupsb | Gender groupsc | ||||
---|---|---|---|---|---|---|
All respondents | <35 | 35–54 | 55+ | Female | Male | |
OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
Dichotomous survey questions response (agree vs. disagree, reference = disagree) | ||||||
I feel highly valued. | 0.45***(0.3–0.68) | 0.21**(0.07–0.64) | 0.47**(0.28–0.8) | 0.63(0.32–1.23) | 0.63*(0.41–0.96) | 0.33***(0.18–0.58) |
I feel supported and listened to by my leadership. | 0.76(0.47–1.22) | 0.44(0.15–1.28) | 0.83(0.43–1.58) | 0.55(0.29–1.05) | 0.66'(0.4–1.07) | 0.87(0.43–1.78) |
I feel comfortable providing feedback or concerns to my leaders. | 0.94(0.61–1.46) | 2.81(0.78–10.15) | 0.8(0.44–1.49) | 1.18(0.61–2.29) | 1.26(0.77–2.08) | 0.75(0.4–1.41) |
I believe my concerns will be acted upon. | 0.57**(0.4–0.81) | 0.59(0.21–1.69) | 0.52**(0.33–0.8) | 0.78(0.44–1.4) | 0.67'(0.44–1.04) | 0.5**(0.3–0.84) |
I am worried about my safety at work. | 1.67**(1.23–2.26) | 1.49(0.57–3.88) | 1.71**(1.21–2.42) | 1.44(0.84–2.46) | 1.47'(0.99–2.2) | 1.84**(1.27–2.67) |
My childcare or caregiving responsibilities are impacting my work. | 2.19***(1.54–3.11) | 1.35(0.47–3.89) | 2.47***(1.68–3.64) | 2.05*(1.05–4) | 2.2***(1.5–3.24) | 2.44***(1.49–3.99) |
I am concerned about loss of income. | 1.12(0.8–1.58) | 1.02(0.39–2.71) | 1.06(0.7–1.6) | 1.18(0.68–2.05) | 0.86(0.56–1.31) | 1.6'(1–2.55) |
I am concerned about loss of my job. | 2.19***(1.42–3.37) | 0.46(0.17–1.23) | 2.21**(1.38–3.53) | 3.21**(1.57–6.55) | 2.47**(1.48–4.14) | 1.51(0.91–2.49) |
Dichotomous survey questions response (yes vs. no, reference = no) | ||||||
I have been given additional tasks. | 1.79***(1.33–2.42) | 2.92*(1.09–7.83) | 1.83**(1.25–2.69) | 1.39(0.81–2.39) | 2.26***(1.53–3.33) | 1.42(0.91–2.19) |
The hours I work decreased. | 0.75(0.52–1.07) | 0.71(0.26–1.91) | 0.83(0.55–1.25) | 0.62'(0.35–1.09) | 0.85(0.54–1.35) | 0.72(0.47–1.09) |
The hours I work increased. | 1.38(0.93–2.04) | 1.25(0.34–4.53) | 1.27(0.79–2.06) | 1.27(0.63–2.55) | 1.75*(1.05–2.91) | 1.08(0.61–1.89) |
Other changes in work. | 0.76(0.47–1.24) | 2.00(0.47–8.46) | 0.87(0.53–1.43) | 0.47(0.16–1.36) | 0.87(0.49–1.53) | 0.62(0.29–1.33) |
Clinician Comments on Open-Ended Support Question
Overall (N=1726) | |
---|---|
Clinicians commented they wanted… | N(%) |
Personal protective equipment (PPE) or other equipment/facility needs | 402 (23.3) |
Communication with leadership | 363 (21.0) |
Compensation | 273 (15.8) |
Working relationships | 259 (15.0) |
Positive comments | 230 (13.3) |
COVID-19 specific training/guidelines | 192 (11.1) |
Non-physician, ancillary, and support staff issues | 169 (9.8) |
COVID-19 screening | 158 (9.2) |
In-personvisits/On-site safety issues | 148 (8.6) |
De-escalation/re-escalation plans | 128 (7.4) |
Flexibility/Autonomy with schedule | 121 (7.0) |
Video visit issues | 117 (6.8) |
Recognition/Appreciation/Positive reinforcement | 77 (4.5) |
Work-life balance | 35 (2.0) |
Total comments | 1726 (100) |