Advertisement

Burnout in chairs of obstetrics and gynecology: Diagnosis, treatment, and prevention

Presidential address

      Abstract

      Objective: The purpose of this study was to determine the prevalence of burnout in chairs of academic departments of obstetrics and gynecology, identify important stressors, and develop strategies to treat and prevent burnout. Study design: We performed a cross-sectional study of 131 chairs in the United States and Puerto Rico. We used a 6-part questionnaire focusing on demographics, potential stressors, satisfaction with personal and professional life, self-efficacy, burnout as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and support from the spouse/partner and family. Statistical analyses were performed with the χ2 test for categorical variables and t test or analysis of variance for continuous variables. Results: Questionnaires were returned from 119 chairs, 110 men and 9 women, a response rate of 91%. Chairs had served an average of 7.2 years. They worked an average of 67.4 hours each week, spending 45% of their time in administrative duties, 31% in patient care, 15% in teaching, and 8% in research. Female chairs worked significantly more hours per week than male chairs, 76.9 versus 66.7 hours (P = .005). Chairs who had served >10 years worked significantly fewer hours each week than did those who had been chairs <5 years, 63.2 versus 69.2 hours (P = .04). The most significant stressors were hospital/departmental budget deficits, Medicare/Medicaid billing audits, loss of key faculty, union disputes, and faculty, resident, and staff dismissals. To deal with stress, chairs most often spent time with family and friends. Twenty-two percent of chairs were somewhat-very dissatisfied with their positions. The MBI-HSS revealed a high subscale score for emotional exhaustion, moderate-high for depersonalization, and high for personal accomplishment. High emotional exhaustion was observed in younger chairs, those who worked nearly 70 hours each week, and those with less spouse/partner support. Burnout was more common in new chairs. Conclusion: Burnout in chairs of obstetrics and gynecology is characterized by a high level of emotional exhaustion, moderate-high depersonalization, and high personal accomplishment. These findings should be used to develop programs to improve the psychologic well-being of our academic leaders. (Am J Obstet Gynecol 2002;186:601-12.)

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Cohen JJ
        Who thought sitting in a chair would be so hard [editorial].
        Acad Med. 1998; 73: 284
        • Maslach C
        • Jackson SE
        • Leiter MP
        Maslach burnout inventory manual. 3rd ed.
        in: : Consulting Psychologists Press, Palo Alto (CA)1996: 3-17 (37)
        • APHA Public Policy Statement 200018
        public health impacts of job stress.
        : American Public Health Association, Washington, DC2000
        • Carey MP
        • Jorgensen RS
        • Weinstock RS
        • Sprafkin RP
        • Lantinga LJ
        • Carnrike CL
        • et al.
        Reliability and validity of the appraisal of diabetes scale.
        J Behav Med. 1991; 14: 43-51
        • Maslach C
        • Jackson SE
        The measurement of experienced burnout.
        J Occup Behav. 1981; 2: 99-113
        • Spanier GB
        Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads.
        J Marriage Fam. 1976; 38: 15-28
        • Pearlin LI
        • Schooler C
        The structure of coping.
        J Health Soc Behav. 1978; 19: 2-21
        • Penkower L
        • Bromet EJ
        • Dew MA
        Husband's layoff and wive's mental health: a prospective analysis.
        Arch Gen Psychiatry. 1988; 45: 994-1000
        • Phelan J
        • Schwartz JE
        • Bromet EJ
        • Dew MA
        • Parkinson DK
        • Schulberg HC
        • et al.
        Work stress, family stress and depression in professional and managerial employees.
        Psychol Med. 1991; 21: 999-1012
        • Bates GW
        • Blackhurst DW
        Leadership qualities of obstetrics and gynecology department chairmen of United States medical schools.
        Am J Obstet Gynecol. 1992; 166: 1102-1111
        • Lee RT
        • Ashforth BE
        On the meaning of Maslach's three dimensions of burnout.
        J Appl Psychol. 1990; 75: 743-747
        • Maslach C
        • Jackson SE
        Burnout in health professions: a social psychological analysis.
        in: Social psychology of health and illness. : Lawrence Erlbaum Associates, Hillsdale (NJ)1982: 227-251
        • Henning K
        • Ey S
        • Shaw D
        Perfectionism, the impostor phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students.
        Med Educ. 1998; 32: 456-464
        • Pellegrini VA
        Physician wellness: is burnout nearby? [presidential address].
        in: Proceedings of the annual meeting of the Obstetrical Society of Philadelphia; 2000 May 11 : The Society, Philadelphia2000
        • Lemkau J
        • Rafferty J
        • Gordon Jr, R
        Burnout and career-choice regret among family practice physicians in early practice.
        Fam Pract Res J. 1994; 14: 213-222
        • Lloyd S
        • Streiner D
        • Shannon S
        Burnout, depression, life and job satisfaction among Canadian emergency physicians.
        J Emerg Med. 1994; 12: 559-565
        • Guntupalli KK
        • Fromm Jr, RE
        Burnout in the internist-intensivist.
        Intensive Care Med. 1996; 22: 625-630
        • Pearse WH
        • Poole KG
        Current trends in obstetric and gynecologic academic faculty manpower.
        Obstet Gynecol. 1995; 86: 1018-1020
        • McMurray JE
        • Linzer M
        • Konrad TR
        • Douglas J
        • Shugerman R
        • Nelson K
        The work lives of women physicians.
        J Gen Intern Med. 2000; 15: 372-380
        • Petersdorf RG
        If I had it do again: suggestions for today's department of medicine chairman.
        Pharos. 1991; (Winter): 12-16
        • Speroff L
        The chair in the 1980's.
        Trans Pac Coast Obstet Gynecol Soc. 1981; 49: 37-46
        • Linn LS
        • Yager J
        • Cope D
        • Leake B
        Health status, job satisfaction, job stress, and life satisfaction among academic and clinical faculty.
        JAMA. 1985; 254: 2775-2782
        • Linn LS
        • Yager J
        • Cope D
        • Leake B
        Factors associated with life satisfaction among practicing internists.
        Med Care. 1986; 24: 830-837
        • Weiner EL
        • Swain GR
        • Wolf B
        • Gottlieb M
        A qualitative study of physicians' own wellness-promotion practices.
        West J Med. 2001; 174: 19-23
      1. CMAJ. 1998; 158: 1191-1195