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Open Access Research article

How does burnout affect physician productivity? A systematic literature review

Carolyn S Dewa13*, Desmond Loong1, Sarah Bonato2, Nguyen Xuan Thanh4 and Philip Jacobs45

Author Affiliations

1 Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada

2 Library Services, Centre for Addiction and Mental Health, 33 Russell Street, Toronto M5S 2S1, Canada

3 Department of Psychiatry, University of Toronto, 250 College Street, Toronto M5T 1R8, Canada

4 Institute of Health Economics, Edmonton T5J 3N4, Canada

5 Department of Medicine, University of Alberta, Edmonton T6G 2R3, Canada

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BMC Health Services Research 2014, 14:325  doi:10.1186/1472-6963-14-325

Published: 28 July 2014

Abstract

Background

Interest in the well-being of physicians has increased because of their contributions to the healthcare system quality. There is growing recognition that physicians are exposed to workplace factors that increase the risk of work stress. Long-term exposure to high work stress can result in burnout. Reports from around the world suggest that about one-third to one-half of physicians experience burnout. Understanding the outcomes associated with burnout is critical to understanding its affects on the healthcare system. Productivity outcomes are among those that could have the most immediate effects on the healthcare system. This systematic literature review is one of the first to explore the evidence for the types of physician productivity outcomes associated with physician burnout. It answers the question, “How does burnout affect physician productivity?”

Methods

A systematic search was performed of: Medline Current, Medline in process, PsycInfo, Embase and Web of Science. The search period covered 2002 to 2012. The searches identified articles about practicing physicians working in civilian settings. Articles that primarily looked only at residents or medical students were excluded. Productivity was captured by hours worked, patients seen, sick leave, leaving the profession, retirement, workload and presenteeism. Studies also were excluded if: (1) the study sample was not comprised of at least 50% physicians, (2) the study did not examine the relationship between burnout and productivity or (3) a validated measure of burnout was not used.

Results

The search identified 870 unique citations; 5 met the inclusion/exclusion criteria. This review indicates that globally there is recognition of the potential impact of physician burnout on productivity. Productivity was examined using: number of sick leave days, work ability, intent to either continue practicing or change jobs. The majority of the studies indicate there is a negative relationship between burnout and productivity. However, there is variation depending on the type of productivity outcome examined.

Conclusions

There is evidence that burnout is associated with decreased productivity. However, this line of inquiry is still developing. A number of gaps are yet to be filled including understanding how to quantify the changes in productivity related to burnout.

Keywords:
Physician; Burnout; Productivity