Poor patient behavior causes burnout in doctors: a study

Poor patient behavior causes burnout in doctors: a study


Physicians who experience ill-treatment and discrimination by patients, their families and visitors are more likely to have symptoms of burnout, according to a study published today in PIT.



This rude behavior was more often directed against doctors of racial and ethnic minorities, although these doctors were not at higher risk of burnout.

The cross-sectional survey was conducted by researchers at the Mayo Clinic, who collected data from 6,512 American physicians from November 20, 2020 to March 23, 2021. The survey questions were adapted from the Association of American Medical Colleges Graduation Questionnaire. Physicians reported the frequency (never, once, several times a week, and several times a week) that they experienced ill-treatment or discrimination by patients, families and visitors over the past year.

In addition, participants stated whether they were physically injured or whether the patient or his family refused care due to the doctor’s appearance.

Of the respondents, 37.6% were women, 70.5% were non-Hispanic whites, 13.3% were non-Hispanic Asians, Indigenous peoples of Hawaii or the Pacific (AAPI), and 7.2% were Hispanic.

Several specializations were represented and most (56.9%) of respondents worked in private practice. Physicians in fields with less direct patient contact, such as pathology or radiology, were at lower risk of ill-treatment and burnout than physicians in fields with more direct patient contact, such as emergency medicine.

Almost one third (29.4%) of physicians stated that they had been subjected to racially or ethnically offensive remarks. A similar number (28.7%) experienced offensive sexist comments. More than one-fifth (20.5%) received unwanted sexual suggestions, and 21.6% said the patient or family member refused care because of the doctor’s visible personal characteristics.

With increasing exposure to these encounters, symptoms of emotional exhaustion, depersonalization, and burnout also grew. Overall, after controlling for other variables, the risk of burnout increased from 27% to 120%.

Treatment of violent and discriminatory patients

Although the burn-out syndrome due to patient interactions has not been thoroughly investigated, previous studies have found that physicians of color and sexual minority physicians face greater discrimination in the workplace. This can negatively affect career paths, well-being and the work environment and can exacerbate the shortage of doctors and differences in health care.

“The burnout is due to a chronic high level of unrelieved work-related stress,” said Liselotte N. Dyrbye, MD, of MHPE, who conducted research at the Mayo Clinic but now works at the University of Colorado School of Medicine. he said Medscape Medical News. “The solution is to improve the training environment and address the system-level factors that cause high stress.”

Although every doctor may experience ill-treatment or discrimination, minority and female doctors are particularly vulnerable.

In fact, only 22% of white physicians received racially motivated remarks, compared to 55.8% of non-Hispanic black physicians and 55.4% of AAPI physicians. Among all doctors, 15% were physically injured. About one-third (31.8%) of non-Hispanic physicians of two or more races said they were physically assaulted — almost twice as many as in any other group.

Female doctors encountered unwanted sexual suggestions and abusive sexist remarks (29.6% and 51%, respectively) much more often than doctors (15.1% and 15%, respectively).

“The data emphasizes that we need a fair and inclusive work environment to improve the working lives of minority doctors,” says Dyrbye. “We need organizational strategies that reduce the frequency of inappropriate behavior of patients, families, and visitors, and ways to deal with them effectively when they occur, in order to foster a culture in which all physicians can thrive.”

Some organizations have developed policies for patient and visitor behavior, similar to those in force at the Mayo Clinic in 2017, to help staff identify worrying patient behavior, take appropriate action, and end care if necessary.

Dyrbye advises doctors to be careful about self-care. “Ways to reduce the risk of burnout include career decisions that maximize your sense of purpose, value and purpose of your work, engaging in coaching from professional certified coaches, working fewer hours, avoiding the delayed mentality mentality, taking vacations . ” and purposefully build social support by taking the time to connect with family, friends and co-workers, ”says Dyrbye.

PIT. Published online May 19, 2022. Full text

Steph Weber is a freelance journalist from the Midwest who specializes in healthcare and law.

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