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A Survey Evaluating Burnout, Health Status, Depression, Reported Alcohol and Substance Use, and Social Support of Anesthesiologists

Hyman, Steve Alan MD*; Shotwell, Matthew S. PhD; Michaels, Damon R. MMHC, BS*; Han, Xue MPH, MS; Card, Elizabeth Borg MSN, APN, FNP-BC, CPAN, CCRP§; Morse, Jennifer L. MS; Weinger, Matthew B. MD*‖¶#

doi: 10.1213/ANE.0000000000002298
Healthcare Economics, Policy, and Organization: Original Clinical Research Report

BACKGROUND: Burnout affects all medical specialists, and concern about it has become common in today’s health care environment. The gold standard of burnout measurement in health care professionals is the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which measures emotional exhaustion, depersonalization (DP), and personal accomplishment. Besides affecting work quality, burnout is thought to affect health problems, mental health issues, and substance use negatively, although confirmatory data are lacking. This study evaluates some of these effects.

METHODS: In 2011, the American Society of Anesthesiologists and the journal Anesthesiology cosponsored a webinar on burnout. As part of the webinar experience, we included access to a survey using MBI-HSS, 12-item Short Form Health Survey (SF-12), Social Support and Personal Coping (SSPC-14) survey, and substance use questions. Results were summarized using sample statistics, including mean, standard deviation, count, proportion, and 95% confidence intervals. Adjusted linear regression methods examined associations between burnout and substance use, SF-12, SSPC-14, and respondent demographics.

RESULTS: Two hundred twenty-one respondents began the survey, and 170 (76.9%) completed all questions. There were 266 registrants total (31 registrants for the live webinar and 235 for the archive event), yielding an 83% response rate. Among respondents providing job titles, 206 (98.6%) were physicians and 2 (0.96%) were registered nurses. The frequency of high-risk responses ranged from 26% to 59% across the 3 MBI-HSS categories, but only about 15% had unfavorable scores in all 3. Mean mental composite score of the SF-12 was 1 standard deviation below normative values and was significantly associated with all MBI-HSS components. With SSPC-14, respondents scored better in work satisfaction and professional support than in personal support and workload. Males scored worse on DP and personal accomplishment and, relative to attending physicians, residents scored worse on DP. There was no significant association between MBI-HSS and substance use.

CONCLUSIONS: Many anesthesiologists exhibit some high-risk burnout characteristics, and these are associated with lower mental health scores. Personal and professional support were associated with less emotional exhaustion, but overall burnout scores were associated with work satisfaction and professional support. Respondents were generally economically satisfied but also felt less in control at work and that their job kept them from friends and family. The association between burnout and substance use may not be as strong as previously believed. Additional work, perhaps with other survey instruments, is needed to confirm our results.

Supplemental Digital Content is available in the text.Published ahead of print October 5, 2017.

From the Departments of *Anesthesiology and Biostatistics, Vanderbilt University School of Medicine and Vanderbilt University Medical Center, Nashville, Tennessee; Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington; §Department of Nursing Research, Vanderbilt Nursing, Vanderbilt University Medical Center, Nashville, Tennessee; Departments of Biomedical Informatics and Medical Education, Vanderbilt University School of Medicine and Vanderbilt University Medical Center, Nashville, Tennessee; and #Geriatric Research Education and Clinical Center, VA Tennessee Valley Healthcare System, Nashville, Tennessee.

Published ahead of print October 5, 2017.

Accepted for publication May 9, 2017.

Funding: Vanderbilt Institute for Clinical and Translational Research (VICTR, #VR8248).

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website.

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Address correspondence to Steve Alan Hyman, MD, Department of Anesthesiology, Vanderbilt University Medical Center, 1301 Medical Center Dr, Nashville, TN 37205. Address e-mail to

© 2017 International Anesthesia Research Society
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