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February 21, 2017; 88 (8) Article

Burnout, career satisfaction, and well-being among US neurologists in 2016

Neil A. Busis, Tait D. Shanafelt, Christopher M. Keran, Kerry H. Levin, Heidi B. Schwarz, Jennifer R. Molano, Thomas R. Vidic, Joseph S. Kass, Janis M. Miyasaki, Jeff A. Sloan, Terrence L. Cascino
First published January 25, 2017, DOI: https://doi.org/10.1212/WNL.0000000000003640
Neil A. Busis
From the Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology and Rehabilitation (J.R.M.), University of Cincinnati, OH; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Department of Neurology (J.S.K.), Baylor College of Medicine, Houston, TX; and Alberta Health Services Medicine (J.M.M.), University of Alberta, Canada.
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Tait D. Shanafelt
From the Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology and Rehabilitation (J.R.M.), University of Cincinnati, OH; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Department of Neurology (J.S.K.), Baylor College of Medicine, Houston, TX; and Alberta Health Services Medicine (J.M.M.), University of Alberta, Canada.
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Christopher M. Keran
From the Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology and Rehabilitation (J.R.M.), University of Cincinnati, OH; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Department of Neurology (J.S.K.), Baylor College of Medicine, Houston, TX; and Alberta Health Services Medicine (J.M.M.), University of Alberta, Canada.
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Kerry H. Levin
From the Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology and Rehabilitation (J.R.M.), University of Cincinnati, OH; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Department of Neurology (J.S.K.), Baylor College of Medicine, Houston, TX; and Alberta Health Services Medicine (J.M.M.), University of Alberta, Canada.
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Heidi B. Schwarz
From the Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology and Rehabilitation (J.R.M.), University of Cincinnati, OH; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Department of Neurology (J.S.K.), Baylor College of Medicine, Houston, TX; and Alberta Health Services Medicine (J.M.M.), University of Alberta, Canada.
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Jennifer R. Molano
From the Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology and Rehabilitation (J.R.M.), University of Cincinnati, OH; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Department of Neurology (J.S.K.), Baylor College of Medicine, Houston, TX; and Alberta Health Services Medicine (J.M.M.), University of Alberta, Canada.
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Thomas R. Vidic
From the Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology and Rehabilitation (J.R.M.), University of Cincinnati, OH; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Department of Neurology (J.S.K.), Baylor College of Medicine, Houston, TX; and Alberta Health Services Medicine (J.M.M.), University of Alberta, Canada.
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Joseph S. Kass
From the Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology and Rehabilitation (J.R.M.), University of Cincinnati, OH; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Department of Neurology (J.S.K.), Baylor College of Medicine, Houston, TX; and Alberta Health Services Medicine (J.M.M.), University of Alberta, Canada.
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Janis M. Miyasaki
From the Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology and Rehabilitation (J.R.M.), University of Cincinnati, OH; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Department of Neurology (J.S.K.), Baylor College of Medicine, Houston, TX; and Alberta Health Services Medicine (J.M.M.), University of Alberta, Canada.
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Jeff A. Sloan
From the Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology and Rehabilitation (J.R.M.), University of Cincinnati, OH; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Department of Neurology (J.S.K.), Baylor College of Medicine, Houston, TX; and Alberta Health Services Medicine (J.M.M.), University of Alberta, Canada.
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Terrence L. Cascino
From the Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA; Division of Hematology (T.D.S.), Division of Biomedical Statistics and Informatics (J.A.S.), and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; Member Insights Department (C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology and Rehabilitation (J.R.M.), University of Cincinnati, OH; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Department of Neurology (J.S.K.), Baylor College of Medicine, Houston, TX; and Alberta Health Services Medicine (J.M.M.), University of Alberta, Canada.
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Citation
Burnout, career satisfaction, and well-being among US neurologists in 2016
Neil A. Busis, Tait D. Shanafelt, Christopher M. Keran, Kerry H. Levin, Heidi B. Schwarz, Jennifer R. Molano, Thomas R. Vidic, Joseph S. Kass, Janis M. Miyasaki, Jeff A. Sloan, Terrence L. Cascino
Neurology Feb 2017, 88 (8) 797-808; DOI: 10.1212/WNL.0000000000003640

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Abstract

Objective: To study prevalence of and factors that contribute to burnout, career satisfaction, and well-being in US neurologists.

Methods: A total of 4,127 US American Academy of Neurology member neurologists who had finished training were surveyed using validated measures of burnout, career satisfaction, and well-being from January 19 to March 21, 2016.

Results: Response rate was 40.5% (1,671 of 4,127). Average age of participants was 51 years, with 65.3% male and nearly equal representation across US geographic regions. Approximately 60% of respondents had at least one symptom of burnout. Hours worked/week, nights on call/week, number of outpatients seen/week, and amount of clerical work were associated with greater burnout risk. Effective support staff, job autonomy, meaningful work, age, and subspecializing in epilepsy were associated with lower risk. Academic practice (AP) neurologists had a lower burnout rate and higher rates of career satisfaction and quality of life than clinical practice (CP) neurologists. Some factors contributing to burnout were shared between AP and CP, but some risks were unique to practice setting. Factors independently associated with profession satisfaction included meaningfulness of work, job autonomy, effectiveness of support staff, age, practicing sleep medicine (inverse relationship), and percent time in clinical practice (inverse relationship). Burnout was strongly associated with decreased career satisfaction.

Conclusions: Burnout is common in all neurology practice settings and subspecialties. The largest driver of career satisfaction is the meaning neurologists find in their work. The results from this survey will inform approaches needed to reduce burnout and promote career satisfaction and well-being in US neurologists.

GLOSSARY

AAN=
American Academy of Neurology;
AP=
academic practice;
CP=
clinical practice;
MBI-HSS=
Maslach Burnout Inventory–Human Services Survey;
QOL=
quality of life

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 726

  • Supplemental data at Neurology.org

  • Received August 31, 2016.
  • Accepted in final form October 27, 2016.
  • © 2017 American Academy of Neurology
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Disputes & Debates: Rapid online correspondence

  • Author response to Prof. Sethi
    • Neil A. Busis, Chief, Section of Neurology, UPMC Shadyside, Pittsburgh, PAbusisna@upmc.edu
    • TD Shanafelt, Rochester, MN; CM Keran, Minneapolis; KH Levin, Cleveland; HB Schwarz, Rochester, NY; JR Molano, Cincinnati; TR Vidic, Elkhart, IN; JS Kass, Houston; JM Miyasaki, Edmonton, AL, Canada; JA Sloan, TL Cascino, Rochester, MN
    Submitted June 16, 2017
  • Author response to Prof. Berger
    • Neil A. Busis, Chief, Section of Neurology, UPMC Shadyside, Pittsburgh, PAbusisna@upmc.edu
    • TD Shanafelt, Rochester, MN; CM Keran, Minneapolis; KH Levin, Cleveland; HB Schwarz, Rochester, NY; JR Molano, Cincinnati; TR Vidic, Elkhart, IN; JS Kass, Houston; JM Miyasaki, Edmonton, AL, Canada; JA Sloan, TL Cascino, Rochester, MN
    Submitted June 16, 2017
  • Burnout among US neurologists
    • Nitin K. Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NYsethinitinmd@hotmail.com
    Submitted June 02, 2017
  • Burnout among neurologist: A unique predisposition?
    • Joseph R. Berger, Professor of Neurology, University of Pennsylvaniajoseph.berger@uphs.upenn.edu
    Submitted June 02, 2017
  • Author response: "Please don't call it burnout"
    • Neil A. Busis, Chief, Section of Neurology, UPMC Shadyside, Pittsburgh, PAbusisna@upmc.edu
    • TD Shanafelt, Rochester, MN; CM Keran, Minneapolis MN; KH Levin, Cleveland, OH; HB Schwarz, Rochester, NY; JR Molano, Cincinnati, OH; TR Vidic, Elkhart, IN; JS Kass, Houston, TX; JM Miyasaki, Edmonton, Alberta, Canada; JA Sloan, TL Cascino, Rochester, MN
    Submitted May 26, 2017
  • Please don't call it burnout
    • Charles S Yanofsky, Neurologist, Geisinger Healthpaneuro@usa.net
    Submitted May 17, 2017
  • Author response to Dr. Giannouli
    • Neil A. Busis, Chief, Section of Neurology, UPMC Shadyside, Pittsburgh, PAbusisna@upmc.edu
    • TD Shanafelt, Rochester, MN; CM Keran, Minneapolis MN; KH Levin, Cleveland, OH; HB Schwarz, Rochester, NY; JR Molano, Cincinnati, OH; TR Vidic, Elkhart, IN; JS Kass, Houston, TX; JM Miyasaki, Edmonton, Canada; JA Sloan, TL Cascino, Rochester, MN
    Submitted May 02, 2017
  • Is it time to consider multilevel analyses as more appropriate when examining burnout among neurologists?
    • Vaitsa Giannouli, Aristotle University of Thessaloniki, Greecegiannouliv@hotmail.com
    Submitted April 14, 2017
  • Author response to Bagot et al.
    • Neil A. Busis, Chief, Section of Neurology, UPMC Shadyside, Pittsburgh, PAbusisna@upmc.edu
    • TD Shanafelt, Rochester, MN; CM Keran, Minneapolis; KH Levin, Cleveland; HB Schwarz, Rochester, NY; JR Molano, Cincinnati; TR Vidic, Elkhart, IN; JS Kass, Houston; JM Miyasaki, Edmonton, Canada; JA Sloan, Rochester, MN; TL Cascino, Rochester, MN
    Submitted April 03, 2017
  • The impact of telemedicine to be considered for neurologists' burnout risk and career satisfaction
    • Kathleen L. Bagot, Research Fellow, The Florey Institute of Neuroscience and Mental Health, University of Melbournekathleen.bagot@florey.edu.au
    • Dominique Cadilhac, Joosup Kim, Clayton, Australia; Michelle Vu, Chris Bladin, Heidelberg, Australia
    Submitted March 28, 2017
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