The Impact of Organizational Leadership on Physician Burnout and Satisfaction
Study Details
Study Description
Brief Summary
Physician burnout is a global issue characterized by emotional exhaustion, depersonalization, and low levels of personal accomplishment. Recent evidence suggests that organization-directed interventions were more likely to lead to reductions in burnout when compared to physician-directed interventions. More specifically, the leadership behaviors of the direct physician supervisor play a critical role in the well-being of physicians they supervise.
As such, the aims of this project are: 1) To improve our understanding of the prevalence of burnout and professional satisfaction of physicians working at the Ottawa Hospital (TOH), and 2) To evaluate the relationship between the leadership qualities of direct physician supervisors (i.e. Division and Department Heads) and the well-being and burnout of their physicians. Specifically, a cross-sectional survey will be completed by physicians at TOH to assess their levels of burnout and satisfaction and the leadership qualities of their direct physician supervisors.
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Detailed Description
Physician burnout is a global issue characterized by emotional exhaustion, depersonalization, and low levels of personal accomplishment. Burnout symptoms as high as 50% have been documented worldwide. According to the 2018 National Physician Health Survey, 30% of Canadian Physicians and Residents are experiencing burnout, with 26% high emotional exhaustion and 15% high depersonalization. Physician burnout is associated with low job satisfaction, decreased quality of patient care, reduced productivity, high job turnover, and early retirement from clinical practice. However, evidence suggests burnout is reversible and even preventable.
Recent evidence suggests that organization-directed interventions were more likely to lead to reductions in burnout when compared to physician-directed interventions. More specifically, the leadership behaviors of the direct physician supervisor play a critical role in the well-being of physicians they supervise. To date, we are unaware of any study that has examined the relationship between organizational leadership and degree of burnout and professional satisfaction in a Canadian tertiary care centre. Understanding physician burnout and professional satisfaction has strategic importance to the health of the physician, the patient, and the organization.
A recent study of 2813 physicians at the Mayo clinic found that each 1-point increase in supervisor's leadership score was associated with a 3.3% decrease in the likelihood of burnout and 9% increase in satisfaction of physicians. Furthermore, 11% and 47% of the variation of burnout and satisfaction, respectively, was attributed to the leadership rating of the physician's supervisor. The findings from this study further highlight the importance of prioritizing leadership as a key performance indicator, but it is necessary to first determine whether the Mayo Clinic's findings can be translated to a Canadian tertiary care centre.
As such, the aims of this project are: 1) To improve our understanding of the prevalence of burnout and professional satisfaction of physicians working at TOH, and 2) To evaluate the relationship between the leadership qualities of direct physician supervisors (i.e. Division and Department Heads) and the well-being and burnout of their physicians.
Our study will use Shanafelt et al's study as a guide to investigate leadership qualities at TOH. A cross-sectional online survey will be completed by physicians at TOH that will assess their levels of burnout and satisfaction and the leadership qualities of their direct physician supervisor.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Physicians at The Ottawa Hospital Online survey completed by physicians working at The Ottawa Hospital consisting of the 2-item Maslach Burnout Inventory, a Satisfaction Questionnaire and the 12-Item Participatory Management Leadership Score. |
Other: Survey
Survey
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Outcome Measures
Primary Outcome Measures
- 2-item Maslach Burnout Inventory (MBI) [Baseline]
Burnout will be assessed by the 2-item version of the MBI.
- Satisfaction Questionnaire [Baseline]
Overall satisfaction with TOH as a health care organization will be evaluated with the following question, rated on a 5-point Likert scale from "very satisfied" to "very dissatisfied": "Considering everything, how would you rate your overall satisfaction with TOH as a whole at the present time?"
- 12-Item Participatory Management Leadership Index [Baseline]
This validated questionnaire assesses the opinion of the leadership qualities of the physician's immediate supervisor. The 12 items assess specific characteristics of leadership that are measurable and actionable. Participants will also be asked to rate their overall satisfaction with their immediate supervisor on a 5-point Likert scale from "very satisfied" to "very dissatisfied".
Eligibility Criteria
Criteria
Inclusion Criteria:
- all physicians working at The Ottawa Hospital
Exclusion Criteria:
- none
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | The Ottawa Hospital | Ottawa | Ontario | Canada |
Sponsors and Collaborators
- University of Ottawa
- The Ottawa Hospital
- The Ottawa Hospital Research Institute
Investigators
- Principal Investigator: Edward Spilg, MBChB, University of Ottawa
Study Documents (Full-Text)
None provided.More Information
Publications
- Arigoni F, Bovier PA, Sappino AP. Trend of burnout among Swiss doctors. Swiss Med Wkly. 2010 Aug 9;140:w13070. doi: 10.4414/smw.2010.13070. eCollection 2010.
- Bianchi R, Schonfeld IS, Laurent E. Burnout-depression overlap: a review. Clin Psychol Rev. 2015 Mar;36:28-41. doi: 10.1016/j.cpr.2015.01.004. Epub 2015 Jan 17. Review.
- Canadian Medical Association. CMA National Physician Health Survey - A National Snapshot. October 2018.
- Collier R. Physician burnout a major concern. CMAJ. 2017 Oct 2;189(39):E1236-E1237. doi: 10.1503/cmaj.1095496.
- Dewa CS, Jacobs P, Thanh NX, Loong D. An estimate of the cost of burnout on early retirement and reduction in clinical hours of practicing physicians in Canada. BMC Health Serv Res. 2014 Jun 13;14:254. doi: 10.1186/1472-6963-14-254.
- Dewa CS, Loong D, Bonato S, Thanh NX, Jacobs P. How does burnout affect physician productivity? A systematic literature review. BMC Health Serv Res. 2014 Jul 28;14:325. doi: 10.1186/1472-6963-14-325. Review.
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- Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory manual. Vol 4: Consulting psychologists press Palo Alto, CA; 1996.
- Panagioti M, Panagopoulou E, Bower P, Lewith G, Kontopantelis E, Chew-Graham C, Dawson S, van Marwijk H, Geraghty K, Esmail A. Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis. JAMA Intern Med. 2017 Feb 1;177(2):195-205. doi: 10.1001/jamainternmed.2016.7674. Review.
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- Shanafelt TD, Gorringe G, Menaker R, Storz KA, Reeves D, Buskirk SJ, Sloan JA, Swensen SJ. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc. 2015 Apr;90(4):432-40. doi: 10.1016/j.mayocp.2015.01.012. Epub 2015 Mar 18.
- Shanafelt TD, Mungo M, Schmitgen J, Storz KA, Reeves D, Hayes SN, Sloan JA, Swensen SJ, Buskirk SJ. Longitudinal Study Evaluating the Association Between Physician Burnout and Changes in Professional Work Effort. Mayo Clin Proc. 2016 Apr;91(4):422-31. doi: 10.1016/j.mayocp.2016.02.001.
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- West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018 Jun;283(6):516-529. doi: 10.1111/joim.12752. Epub 2018 Mar 24. Review.
- Williams ES, Manwell LB, Konrad TR, Linzer M. The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study. Health Care Manage Rev. 2007 Jul-Sep;32(3):203-12.
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