Brigitta Zumbrunn1, Odile Stalder2, Andreas Limacher2, Peter E Ballmer3, Stefano Bassetti4, Edouard Battegay5, Jürg Hans Beer6, Michael Brändle7, Daniel Genné8, Daniel Hayoz9, Christoph Henzen10, Lars Chistian Huber11, Pierre-Auguste Petignat12, Jean-Luc Reny13, Peter Vollenweider14, Drahomir Aujesky1. 1. Department of General Internal Medicine, Bern University Hospital, Inselspital, Bern, Switzerland. 2. CTU Bern, and Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland. 3. Department of Internal Medicine, Kantonsspital Winterthur, Switzerland. 4. Division of Internal Medicine, University Hospital Basel, Switzerland. 5. Department of Internal Medicine, University Hospital Zurich, Switzerland. 6. Department of Internal Medicine, Cantonal Hospital of Baden, Switzerland. 7. Department of Internal Medicine, Cantonal Hospital of St Gallen, Switzerland. 8. Department of Internal Medicine, Cantonal Hospital of Biel, Switzerland. 9. Department of Internal Medicine, Cantonal Hospital of Fribourg, Switzerland. 10. Department of Internal Medicine, Cantonal Hospital of Lucerne, Switzerland. 11. Department of Internal Medicine, City Hospital Triemli, Zurich, Switzerland. 12. Department of Internal Medicine, Hospital of Valais, Sion, Switzerland. 13. Division of General Internal Medicine, Geneva University Hospitals, and Faculty of Medicine, Geneva University, Geneva, Switzerland. 14. Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Abstract
BACKGROUND: Physician well-being has an impact on productivity and quality of care. Residency training is a particularly stressful period. OBJECTIVE: To assess the well-being of general internal medicine (GIM) residents and its association with personal and work-related factors. METHODS: We conducted an anonymous electronic survey among GIM residents from 13 Swiss teaching hospitals. We explored the association between a reduced well-being (≥5 points based on the Physician Well-Being Index [PWBI]) and personal and work-related factors using multivariable mixed-effects logistic regression. RESULTS: The response rate was 54% (472/880). Overall, 19% of residents had a reduced well-being, 60% felt burned out (emotional exhaustion), 47% were worried that their work was hardening them emotionally (depersonalisation), and 21% had career choice regret. Age (odds ratio [OR] 1.19, 95% confidence interval [CI] 1.05–1.34), working hours per week (OR 1.04 per hour, 95% CI 1.01–1.07) and <2.5 rewarding work hours per day (OR 3.73, 95% CI 2.01–6.92) were associated with reduced well-being. Administrative workload and satisfaction with the electronic medical record were not. We found significant correlations between PWBI score and job satisfaction (rs = -0.54, p<0.001), medical errors (rs = 0.18, p<0.001), suicidal ideation (rs = 0.12, p = 0.009) and the intention to leave clinical practice (rs = 0.38, p <0.001) CONCLUSIONS: Approximately 20% of Swiss GIM residents appear to have a reduced well-being and many show signs of distress or have career choice regret. Having few hours of rewarding work and a high number of working hours were the most important modifiable predictors of reduced well-being. Healthcare organisations have an ethical responsibility to implement interventions to improve physician well-being.
BACKGROUND: Physician well-being has an impact on productivity and quality of care. Residency training is a particularly stressful period. OBJECTIVE: To assess the well-being of general internal medicine (GIM) residents and its association with personal and work-related factors. METHODS: We conducted an anonymous electronic survey among GIM residents from 13 Swiss teaching hospitals. We explored the association between a reduced well-being (≥5 points based on the Physician Well-Being Index [PWBI]) and personal and work-related factors using multivariable mixed-effects logistic regression. RESULTS: The response rate was 54% (472/880). Overall, 19% of residents had a reduced well-being, 60% felt burned out (emotional exhaustion), 47% were worried that their work was hardening them emotionally (depersonalisation), and 21% had career choice regret. Age (odds ratio [OR] 1.19, 95% confidence interval [CI] 1.05–1.34), working hours per week (OR 1.04 per hour, 95% CI 1.01–1.07) and <2.5 rewarding work hours per day (OR 3.73, 95% CI 2.01–6.92) were associated with reduced well-being. Administrative workload and satisfaction with the electronic medical record were not. We found significant correlations between PWBI score and job satisfaction (rs = -0.54, p<0.001), medical errors (rs = 0.18, p<0.001), suicidal ideation (rs = 0.12, p = 0.009) and the intention to leave clinical practice (rs = 0.38, p <0.001) CONCLUSIONS: Approximately 20% of Swiss GIM residents appear to have a reduced well-being and many show signs of distress or have career choice regret. Having few hours of rewarding work and a high number of working hours were the most important modifiable predictors of reduced well-being. Healthcare organisations have an ethical responsibility to implement interventions to improve physician well-being.