title: Burnout among young physicians and its association with physicians' wishes to leave: results of a survey in Saxony, Germany.
abstract: BACKGROUND
  Concerns about burnout, and its consequences, among German physicians are rising. However, data on burnout among German physicians are scarce. Also, a suspected association between burnout and German physicians' wishes to leave remains to be studied. Therefore, the extent of burnout, and the association between burnout and wishes to leave clinical practice or to go abroad for clinical work was studied in a sample of young physicians in Saxony.
  
  
  METHODS
  In a cross-sectional survey, all physicians ≤40 years and registered with the State Chamber of Physicians of Saxony, Germany (n = 5956) received a paper-pencil questionnaire inquiring about socio-demographics, job satisfaction, and wishes to leave clinical practice or to go abroad for clinical work. Response rate was 40 % (n = 2357). Burnout was measured with the German version of the Maslach Burnout Inventory - Human Services Survey (MBI) consisting of the subscales emotional exhaustion (feeling emotionally drained), depersonalization (feelings of cynicsm) and personal accomplishment (feelings of personal achievement in job). Variables associated with burnout, and the association between burnout and wishes to leave were assessed in multivariate logistic regression analyses.
  
  
  RESULTS
  For emotional exhaustion participants reached a mean of 21.3 [standard deviation = 9.74], for depersonalization a mean of 9.9 [5.92], and for personal accomplishment a mean of 36.3 [6.77]. Men exhibited significantly higher depersonalization than women (11.3 [6.11] versus 9 [5.62], p < 0.001). Eleven percent of participants showed a high degree of burnout on all subscales, while 35 % did not show a high degree of burnout on any subscale. Confirming that one would become a physician again, and higher satisfaction with the components "work environment" and "humaneness", were associated with a lower chance for a high degree of burnout on all subscales. Higher emotional exhaustion and lower personal accomplishment were associated with an increased chance of wishing to leave clinical practice. Higher emotional exhaustion and higher depersonalization were associated with an increased chance of wishing to go abroad for clinical work.
  
  
  CONCLUSIONS
  Preventing physician burnout may not only benefit the affected individual. It may also benefit the health care system by potentially preventing physicians from leaving clinical practice or from going abroad for clinical work.
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany.
authors.forename: Birte
authors.initials: B
authors.lastname: Pantenburg
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany.
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.affiliation: Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany.
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
keywords: Burnout; Maslach Burnout Inventory; Physician attrition; Physicians’ wishes to leave