P012: Does physician burnout differ between urban and rural emergency medicine physicians? A comparison using the Maslach Burnout Inventory tool

Introduction: Previous literature suggests that emergency medicine physicians experience high levels of work-related burnout. However, these results are drawn primarily from physicians working in large urban emergency departments. The aim of this study was to compare physician wellness between emergency medicine physicians working in urban versus rural settings. Methods: Emergency medicine physicians were recruited to complete a wellness survey from both urban and rural emergency medicine departments in Southwestern Ontario. The primary outcome measure of interest was physician burnout as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). This survey tool measures physician burnout in the three domains of emotional exhaustion, depersonalization, and personal accomplishment. Descriptive statistics, paired t-tests and Mann-Whitney U tests were used to analyze parametric and non-parametric burnout domain data respectively. Results: Surveys were completed by 67/99 (68%) and 22/66 (33%) of urban and rural emergency medicine physicians, respectively. An emotional exhaustion score ≥27 OR a depersonalization sub-score ≥10 was considered the threshold for burnout and was found in 71.4% (40/56) of urban physicians surveyed and 85.7% (18/21) (P = 0.20) of rural physicians. No statistically significant difference in mean emotional exhaustion, depersonalization, or personal accomplishment was noted between groups. Conclusion: High levels of burnout were noted amongst both urban and rural emergency medicine physicians. No statistically significant differences were noted between groups when compared on the Maslach Burnout Inventory survey tool. Despite many factors differentiating urban from rural practice, rural emergency doctors suffer similar rates of burnout. Thematic qualitative interviews exploring specific burnout factors may offer further insight into the drivers of physician burnout.