Panagioti M, et al. - This meta-analysis was conducted to determine whether physician burnout is related to an increased risk of patient safety incidents, suboptimal care outcomes due to low professionalism, and poorer patient satisfaction. Findings showed that physician burnout may result in jeopardized patient care, and reversal of this risk should be considered a worldwide health-care policy goal. These data call for efforts by health-care organizations to improve physician wellness, particularly for early-career physicians. Improvements in the methods of recording patient care quality and safety outcomes are required to concisely document the effects of physician burnout on the performance of health-care organizations.

Methods

• Using combinations of the key terms physicians, burnout, and patient care, researchers performed detailed standardized searches, with no language restriction, through MEDLINE, EMBASE, PsycInfo, and CINAHL databases until October 22, 2017.
• Hand-searched reference lists of eligible studies and other relevant systematic reviews were included.
• Quantitative observational studies were selected, and two independent reviewers were involved.
• Subgroup and sensitivity analyses were conducted following the main meta-analysis, and all analyses were performed using random-effects models.
• Formal tests for heterogeneity (I²) and publication bias were also undertaken.
• The main outcomes of interest were the quantitative links between burnout and patient safety, professionalism, and patient satisfaction, which were reported as odds ratios (ORs) with their 95% confidence intervals (CIs).

Results

• Researchers identified a total of 5,234 records.
• The meta-analysis included 47 studies on 42,473 physicians (25,059 [59.0%] men; median age, 38 years [range: 27-53 years]).
• There was an association between physician burnout and an increased risk of patient safety incidents (OR: 1.96; 95% CI: 1.59–2.40), poorer quality of care due to low professionalism (OR: 2.31; 95% CI: 1.87–2.85), and attenuated patient satisfaction (OR: 2.28; 95% CI: 1.42–3.68).
• High heterogeneity and low to moderate study quality were reported.
• In residents and early-career (≤5 years post residency) physicians versus middle- and late-career physicians (Cohen Q=7.27; P=0.003), larger links between burnout and low professionalism were observed.
• The main results (Cohen Q=8.14; P=0.007) were remarkably affected by the reporting method of patient safety incidents and professionalism (physician-reported vs system-recorded).