Emergency Physicians Under More Stress Than Other Physicians

Poor teamwork and tension between home and working life are the key factors that cause one in two emergency care doctors in France to be prone to burn-out, according to a new survey.

Researchers at several hospitals belonging to the Hôpitaux de Paris (France) conducted a study involving 3,196 salaried doctors that completed an online survey designed to assess working conditions, job satisfaction, and health and wellbeing, using a five-point scale for more than 250 questions. Of these, 538 were emergency care specialists, and of the remainder, 1,924 physicians were randomly selected to match the age, gender, and regional profile of physicians in France and their distribution by specialty, to provide a representative sample. The specialties represented included intensive care and anesthetics, medicine, surgery, psychiatry, geriatric medicine, radiology, preventive medicine, and pharmacy.

The results of the survey indicated that the intent to leave the profession (ITL) was quite prevalent across French physicians (17.4%), and even more so among emergency physicians (21.4%), and burnout was highly prevalent (42.4% and 51.5%, respectively). Among the representative sample and among emergency physicians, work–family conflict and quality of teamwork were associated with burnout in a multivariate analysis, and these risk factors were more prevalent among emergency physicians than other types. A serious lack of quality of teamwork appears to be associated with a higher risk of ITL, and burnout doubled the risk of ITL in multivariate analysis. The survey was published online on December 1, 2010, in the BMJ publication Emergency Medicine Journal.

"Burnt-out emergency care doctors tended to have a less active social life, to smoke more, eat a less healthy diet and to skip meals during the day more than the sample,” concluded lead author Madeleine Estryn-Behar, MD, PhD, of the department of occupational medicine, and colleagues. "In order to prevent the premature departure of French doctors, it is important to improve work–family balance, working processes through collaboration, multidisciplinary teamwork and to develop team training approaches and ward design to facilitate teamwork.”

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