title: Impact of Burnout on Self-Reported Patient Care Among Emergency Physicians.
abstract: BACKGROUND
  Burnout is a syndrome of depersonalization, emotional exhaustion and sense of low personal accomplishment. Emergency physicians (EPs) experience the highest levels of burnout among all physicians. Burnout is associated with greater rates of self-reported suboptimal care among surgeons and internists. The association between burnout and suboptimal care among EPs is unknown. The objective of the study was to evaluate burnout rates among attending and resident EPs and examine their relationship with self-reported patient care practices.
  
  
  METHODS
  In this cross-sectional study burnout was measured at two university-based emergency medicine residency programs with the Maslach Burnout Inventory. We also measured depression, quality of life (QOL) and career satisfaction using validated questionnaires. Six items assessed suboptimal care and the frequency with which they were performed.
  
  
  RESULTS
  We included 77 out of 155 (49.7%) responses. The EP burnout rate was 57.1%, with no difference between attending and resident physicians. Residents were more likely to screen positive for depression (47.8% vs 18.5%, p=0.012) and report lower QOL scores (6.7 vs 7.4 out of 10, p=0.036) than attendings. Attendings and residents reported similar rates of career satisfaction (85.2% vs 87.0%, p=0.744). Burnout was associated with a positive screen for depression (38.6% vs 12.1%, p=0.011) and lower career satisfaction (77.3% vs 97.0%, p=0.02). EPs with high burnout were significantly more likely to report performing all six acts of suboptimal care.
  
  
  CONCLUSIONS
  A majority of EPs demonstrated high burnout. EP burnout was significantly associated with higher frequencies of self-reported suboptimal care. Future efforts to determine if provider burnout is associated with negative changes in actual patient care are necessary.
authors.affiliation: Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois.
authors.forename: Dave W
authors.initials: DW
authors.lastname: Lu
authors.affiliation: Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois.
authors.forename: Scott
authors.initials: S
authors.lastname: Dresden
authors.affiliation: Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois.
authors.forename: Colin
authors.initials: C
authors.lastname: McCloskey
authors.affiliation: University of Washington School of Medicine, Department of Emergency Medicine, Seattle, Washington.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Branzetti
authors.affiliation: Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gisondi
mesh_terms: D002055:Burnout, Professional / Q000523:psychology*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards*; D003863:Depression / Q000523:psychology; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007588:Job Satisfaction; D008297:Male; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000592:standards; D011788:Quality of Life; D057566:Self Report