A study published in the February issue of JAMA Internal Medicine found that interventions implemented at the organizational level are more effective in combating physician burnout than interventions directed at individuals.

Burnout is an insidious psychological phenomenon consisting of two main elements: depersonalization and emotional exhaustion. Burnout impairs not only the physician's ability to provide optimum care for patients, but it also can have a devastating impact on the physician's personal life, as evidenced by physician suicide rates that are twice the national average. Recent studies have shown that 75 percent of California doctors are showing signs of burnout.

Organization adjustments that were found to decrease physician burnout included: scheduling changes, reductions in the intensity of workload, improved teamwork, changes in work evaluation, supervision to reduce job demand and enhance job control, and increasing the level of participation in decision making.

The study looked at 20 burnout interventions that had been previously published in peer review publications. Researchers found that organization-directed interventions were associated with statistically significant reductions in burnout—particularly interventions that modified resources, the working environment or work tasks to decrease stress. The study looked at more than 1,500 physicians from a range of specialties.

Interventions that combined several elements tended to be the most effective in reducing burnout, but researchers found that this type of complex intervention was very rare.

“The majority of organization-directed interventions that we included in the analyses introduced simple reductions in the workload or schedule changes. Concerns about implementation and delivery costs of organization-directed interventions, especially if they involve complex and major health care system changes, might explain their scarcity,” said lead author Maria Panagioti, Ph.D.

Researchers concluded that more effective models for burnout intervention are needed to mitigate risk for burnout in physicians. Such models could be organization-directed approaches that promote healthy individual-organization relationships.