title: Longitudinal Study Evaluating the Association Between Physician Burnout and Changes in Professional Work Effort.
abstract: OBJECTIVE
  To longitudinally evaluate the relationship between burnout and professional satisfaction with changes in physicians' professional effort.
  
  
  METHODS
  Administrative/payroll records were used to longitudinally evaluate the professional work effort of faculty physicians working for Mayo Clinic from October 1, 2008, to October 1, 2014. Professional effort was measured in full-time equivalent (FTE) units. Physicians were longitudinally surveyed in October 2011 and October 2013 with standardized tools to assess burnout and satisfaction.
  
  
  RESULTS
  Between 2008 and 2014, the proportion of physicians working less than full-time at our organization increased from 13.5% to 16.0% (P=.05). Of the 2663 physicians surveyed in 2011 and 2776 physicians surveyed in 2013, 1856 (69.7%) and 2132 (76.9%), respectively, returned surveys. Burnout and satisfaction scores in 2011 correlated with actual reductions in FTE over the following 24 months as independently measured by administrative/payroll records. After controlling for age, sex, site, and specialty, each 1-point increase in the 7-point emotional exhaustion scale was associated with a greater likelihood of reducing FTE (odds ratio [OR], 1.43; 95% CI, 1.23-1.67; P<.001) over the following 24 months, and each 1-point decrease in the 5-point satisfaction score was associated with greater likelihood of reducing FTE (OR, 1.34; 95% CI, 1.03-1.74; P=.03). On longitudinal analysis at the individual physician level, each 1-point increase in emotional exhaustion (OR, 1.28; 95% CI, 1.05-1.55; P=.01) or 1-point decrease in satisfaction (OR, 1.67; 95% CI, 1.19-2.35; P=.003) between 2011 and 2013 was associated with a greater likelihood of reducing FTE over the following 12 months.
  
  
  CONCLUSIONS
  Among physicians in a large health care organization, burnout and declining satisfaction were strongly associated with actual reductions in professional work effort over the following 24 months.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, MN. Electronic address: shanafelt.tait@mayo.edu.
authors.forename: Tait D
authors.initials: TD
authors.lastname: Shanafelt
authors.affiliation: Human Resources, Mayo Clinic, Jacksonville, FL.
authors.forename: Michelle
authors.initials: M
authors.lastname: Mungo
authors.affiliation: Human Resources, Mayo Clinic, Rochester, MN.
authors.forename: Jaime
authors.initials: J
authors.lastname: Schmitgen
authors.affiliation: Sirota Survey Intelligence, Purchase, NY.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Storz
authors.affiliation: Sirota Survey Intelligence, Purchase, NY.
authors.forename: David
authors.initials: D
authors.lastname: Reeves
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Sharonne N
authors.initials: SN
authors.lastname: Hayes
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN; Office of Organization and Leadership Development, Mayo Clinic, Rochester, MN.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Swensen
authors.affiliation: Department of Radiology, Mayo Clinic, Jacksonville, FL.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Buskirk
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology*; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D011361:Professional Competence; D011795:Surveys and Questionnaires; D014481:United States