title: Emergency Psychiatry Experience, Resident Burnout, and Future Plans to Treat Publicly Funded Patients.
abstract: OBJECTIVE
  This study examined psychiatry resident burnout in emergency departments and its association with residents' posttraining plans to care for Medicaid patients and others publicly insured.
  
  
  METHODS
  Between November and December 2013, psychiatry residents in North Carolina were recruited for a cross-sectional, Internet-based survey concerning emergency department experiences, attitudes about their roles, feelings of burnout, and posttraining intentions to treat Medicaid patients. The completion rate was 51% (N=91).
  
  
  RESULTS
  In bivariate analyses (N=82 with an emergency psychiatry rotation), burnout was positively associated with frequent exhaustion (p<.001) and perceived suboptimal supervision by the attending physician (p<.01). Compared with other residents, residents planning to accept Medicaid after training had significantly lower burnout scores (p<.05). Experiencing assault in the emergency department indicated decreased likelihood of treating publicly insured patients after training (Medicaid, odds ratio=.09, p<.05).
  
  
  CONCLUSIONS
  Adverse experiences with patient care in the emergency department during psychiatry residency appear to be linked to professional burnout and threaten to shape long-term plans regarding care for publicly insured patients.
authors: The authors are with the Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (e-mail: nora.dennis@dm.duke.edu ). Dr. Dennis is also with the Mental Health Service Line, Durham Veterans Affairs Medical Center.
authors: Nora M
authors: NM
authors: Dennis
authors: The authors are with the Department of Psychiatry, Duke University Medical Center, Durham, North Carolina (e-mail: nora.dennis@dm.duke.edu ). Dr. Dennis is also with the Mental Health Service Line, Durham Veterans Affairs Medical Center.
authors: Marvin S
authors: MS
authors: Swartz
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000523:psychology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid; D011570:Psychiatry / Q000193:education*; D014481:United States