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November 13, 2018; 91 (20) Article

Age and sex differences in burnout, career satisfaction, and well-being in US neurologists

Kathrin LaFaver, Janis M. Miyasaki, Christopher M. Keran, Carol Rheaume, Lisa Gulya, Kerry H. Levin, Elaine C. Jones, Heidi B. Schwarz, Jennifer R. Molano, Amy Hessler, Divya Singhal, Tait D. Shanafelt, Jeff A. Sloan, Paul J. Novotny, Terrence L. Cascino, Neil A. Busis
First published October 10, 2018, DOI: https://doi.org/10.1212/WNL.0000000000006497
Kathrin LaFaver
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Janis M. Miyasaki
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Christopher M. Keran
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Carol Rheaume
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Lisa Gulya
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Kerry H. Levin
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Elaine C. Jones
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Heidi B. Schwarz
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Jennifer R. Molano
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Amy Hessler
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Divya Singhal
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Tait D. Shanafelt
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Jeff A. Sloan
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Paul J. Novotny
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Terrence L. Cascino
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Neil A. Busis
From the Department of Neurology (K.L.), University of Louisville, KY; Department of Medicine (J.M.M.), University of Alberta, Canada; Member Insights Department (C.M.K., C.R., L.G.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (K.H.L.), Cleveland Clinic, OH; Consulting Neurologist (E.C.J.), Specialists on Call, Bristol, RI; Department of Neurology (H.B.S.), University of Rochester School of Medicine and Dentistry, NY; Department of Neurology and Rehabilitation Medicine (J.R.M.), University of Cincinnati College of Medicine, OH; Department of Neurology (A.H.), University of Kentucky College of Medicine, Lexington; Department of Neurology (D.S.), University of Oklahoma College of Medicine, Oklahoma City; WellMD Center (T.D.S.), Stanford Medicine, CA; Division of Biomedical Statistics and Informatics (J.A.S., P.J.N.) and Department of Neurology (T.L.C.), Mayo Clinic, Rochester, MN; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA.
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Age and sex differences in burnout, career satisfaction, and well-being in US neurologists
Kathrin LaFaver, Janis M. Miyasaki, Christopher M. Keran, Carol Rheaume, Lisa Gulya, Kerry H. Levin, Elaine C. Jones, Heidi B. Schwarz, Jennifer R. Molano, Amy Hessler, Divya Singhal, Tait D. Shanafelt, Jeff A. Sloan, Paul J. Novotny, Terrence L. Cascino, Neil A. Busis
Neurology Nov 2018, 91 (20) e1928-e1941; DOI: 10.1212/WNL.0000000000006497

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Abstract

Objective To examine age and sex differences in burnout, career satisfaction, and well-being in US neurologists.

Methods Quantitative and qualitative analyses of men's (n = 1,091) and women's (n = 580) responses to a 2016 survey of US neurologists.

Results Emotional exhaustion in neurologists initially increased with age, then started to decrease as neurologists got older. Depersonalization decreased as neurologists got older. Fatigue and overall quality of life in neurologists initially worsened with age, then started to improve as neurologists got older. More women (64.6%) than men (57.8%) met burnout criteria on univariate analysis. Women respondents were younger and more likely to work in academic and employed positions. Sex was not an independent predictive factor of burnout, fatigue, or overall quality of life after controlling for age. In both men and women, greater autonomy, meaning in work, reasonable amount of clerical tasks, and having effective support staff were associated with lower burnout risk. More hours worked, more nights on call, higher outpatient volume, and higher percent of time in clinical practice were associated with higher burnout risk. For women, greater number of weekends doing hospital rounds was associated with higher burnout risk. Women neurologists made proportionately more negative comments than men regarding workload, work–life balance, leadership and deterioration of professionalism, and demands of productivity eroding the academic mission.

Conclusions We identified differences in burnout, career satisfaction, and well-being in neurologists by age and sex. This may aid in developing strategies to prevent and mitigate burnout and promote professional fulfillment for different demographic subgroups of neurologists.

Glossary

AAN=
American Academy of Neurology;
CI=
confidence interval;
MBI-HSS=
Maslach Burnout Inventory–Human Services Survey;
QOL=
quality of life

Footnotes

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

  • Editorial, page 907

  • CME Course: NPub.org/cmelist

  • Received September 6, 2017.
  • Accepted in final form August 5, 2018.
  • © 2018 American Academy of Neurology
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Letters: Rapid online correspondence

  • Author response: Age and sex differences in burnout, career satisfaction, and well-being in US neurologists
    • Kathrin LaFaver, Neurologist, University of Louisville, Department of Neurology
    • Janis M. Miyasaki, Professor of Medicine, University of Alberta (Edmonton, Canada)
    • Christopher M. Keran, Senior Director, Member Insights Department, American Academy of Neurology
    • Carol Rheaume, Senior Research Analyst, American Academy of Neurology
    • Lisa Gulya, Research Analyst, American Academy of Neurology
    • Kerry H. Levin, Neurologist, Cleveland Clinic, Department of Neurology
    • Elaine C. Jones, Neurologist, SOC Telemed
    • Heidi B. Schwarz, Neurologist, University of Rochester School of Medicine and Dentistry, Department of Neurology
    • Jennifer R. Molano, Neurologist, University of Cincinnati College of Medicine, Department of Neurology and Rehabilitation Medicine
    • Amy Hessler, Neurologist, University of Kentucky
    • Divya Singhal, Neurologist, University of Oklahoma
    • Tait D. Shanafelt, MD, Stanford University
    • Jeff A. Sloan, PhD, Mayo Clinic
    • Paul J. Novotny, Assistant Professor of Biostatistics, Mayo Clinic, Division of Biomedical Statistics and Informatics
    • Terrence L. Cascino, Neurologist, Mayo Clinic
    • Neil A. Busis, Neurologist, University of Pittsburgh School of Medicine, Department of Neurology
    Submitted January 06, 2019
  • Reader response: Age and sex differences in burnout, career satisfaction, and well-being in US neurologists
    • Maria Philip, Neurologist, Texas Neurology
    • Robert Connors, Neurologist, Progressive Neurology
    • Garth Turner, Neurologist, Summit Medical Group
    Submitted December 18, 2018
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