Burnout in hospital-based medical consultants in the New Zealand public health system

Aim To assess the prevalence and severity of burnout in hospital-based medical consultants, and investigate associated demographic and professional characteristics. Method Utilising standardised measures of burnout (Maslach Burnout Inventory) and job satisfaction (Job Satisfaction Scale) this cross-sectional study recruited 267 consultants working in a large tertiary hospital in Christchurch, New Zealand. Results Seventy-one percent of all eligible participants were recruited. The prevalence of burnout in each of the three dimensions was as follows: High Emotional Exhaustion=29.7%; High Depersonalisation=24.4%; Low Personal Accomplishment=31.2%. One in five consultants was assessed as having high overall burnout. Considered against the psychometric norms for medical workers, significantly more consultants than expected reported low Emotional Exhaustion (p<0.001) and low Depersonalisation (p<0.01). Working longer hours (p<0.01), lower job satisfaction (p<0.001), and shorter time in the current job (p<0.05) independently increased the risk of high Emotional Exhaustion. Working longer hours (p<0.05) and lower job satisfaction (p<.01) independently increased the risk of high Depersonalisation. Longer time in the same job increased the risk of low Personal Accomplishment (p<0.05). Longer hours worked (p<0.05), shorter vocational experience as a consultant (p<0.05), and lower job satisfaction (p<0.001) independently increased the risk of high overall burnout. Conclusion An unexpected proportion of consultants experience robust emotional well-being and healthy work engagement. However, for those experiencing high burnout, by severity or dimension, working long hours and low job satisfaction appear to be particularly contributory factors. Whilst remedial interventions should target the minority who experience significant burnout, studies using robust research designs are required to assess the meaningful clinical utility of these. The challenge remains to determine the optimal organisational practices to minimise burnout in this workforce. Professional burnout is a prevalent problem in medical consultants 1 and has been described as “a well-entrenched professional norm”. 2, p338 Although there is still ongoing debate about definitions of burnout, there is general consensus that the construct refers to a prolonged response to chronic emotional stressors on the job, and that it can be experienced on three distinct dimensions: high levels of emotional exhaustion, high levels of Depersonalisation/detachment, or low levels of personal accomplishment. Depersonalisation (and the related cynicism or emotional numbing) may be protective, but emotional exhaustion is the most damaging aspect through its stronger