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Physician Burnout Tied to Taking Less Vacation Days, Working on Vacation – Renal and Urology News

The number of vacation days taken and completing patient-related work on vacation are associated with physician burnout, according to study findings published in JAMA Network Open.

Taking vacation time has been shown to have benefits for the employee and employer, such as greater job satisfaction, improved job performance, and lower absenteeism. Despite the benefits of taking time away from work, fewer than half (48%) of workers in the United States (US) with paid time off use all of their allotted time.

To evaluate vacation trends and their outcomes among physicians in the US, researchers conducted a cross-sectional study using data from a nationally representative sample of physicians surveyed between November 2020 and March 2021. The researchers surveyed physicians of all specialties who were listed in the Physician Professional Data. A vacation-related subsurvey was randomly sent to a portion of physicians.

The study population comprised 3024 physicians (62.0% men; 27.1% aged 55-64). The most common specialties were internal medicine (10.0%), psychiatry (8.6%), surgery (8.0%), and family medicine (7.5%); most of the physicians (55.7%) were in private practice. The physicians worked a median of 50 hours per week, and 31.7% received more than 75% of their compensation based on productivity.

Normalizing the expectation that physicians take time off and fully disconnect from clinical work while away may also be beneficial at both the organizational and professional level.

The physicians took >15 (40.4%), 6 to 15 (39.7%), and ≤5 (19.9%) days of vacation in the previous 12 months. While 49.1% had full electronic health record (EHR) inbox coverage, the majority of physicians (70.4%) worked while on vacation. A total of 33.1% of physicians spent ≥30, 37.3% spent 1-30, and 29.6% spent 0 minutes working on patient-related tasks per day.

The number of vacation days varied by specialty. Compared with family medicine physicians, physical medicine and rehabilitation physicians, internists, and emergency medicine physicians, anesthesiologists, radiologists, and radiology oncologists were more likely to take ≥3 weeks of vacation. While on vacation, compared with urologists, neurologists, and surgeons, fewer emergency medicine physicians, radiologists, and pathologists completed ≥30 minutes of work per day.

Common barriers to taking vacation included finding a coworker to cover clinical responsibilities, the financial impact, and the volume of EHR work upon returning from vacation.

In general, emotional exhaustion, depersonalization, overall burnout, and professional fulfillment scores were proportionate to the number of vacation days taken, EHR inbox coverage on vacation, and time spent working while on vacation (all P ≤.007).

Taking ≥15 days of vacation was negatively associated with:

  • having very much (odds ratio [OR], 0.30; 95% CI, 0.21-0.43), quite a bit (OR, 0.48; 95% CI, 0.35-0.65), or moderate (OR, 0.77; 95% CI, 0.61-0.99) concern about finding someone to cover clinical responsibilities;
  • having very much (OR, 0.38; 95% CI, 0,27-0.54), quite a bit (OR, 0.49; 95% CI, 0.36-0.66), or moderate (OR, 0.71; 95% CI, 0.55-0.93) concerns about finances;
  • working at an active military practice (OR, 0.26; 95% CI, 0.07-0.76), in emergency medicine (OR, 0.45; 95% CI, 0.28-0.72), and a Veterans Administration hospital (OR, 0.57; 95% CI, 0.33-0.97); and
  • each additional hour of work per week (OR, 0.99; 95% CI, 0.99-1.00).

This study may have been limited by not including questions about paid time off for family leave, illness, or attending professional meetings. The survey also had a low participation rate.

“Normalizing the expectation that physicians take time off and fully disconnect from clinical work while away may also be beneficial at both the organizational and professional level. Such efforts may be critical and tangible system-based approaches to mitigate the high rates of occupational burnout among physicians,” the researchers concluded.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

This article originally appeared on Neurology Advisor

References:

Sinsky CA, Trockel MT, Dyrbye LN, et al. Vacation days taken, work during vacation, and burnout among us physicians. JAMA Netw Open. Published online January 12, 2024. doi:10.1001/jamanetworkopen.2023.51635