Panagioti M, et al. - Researchers assessed the potential association of physician burnout with increased risk of patient safety incidents, suboptimal care outcomes due to low professionalism, and lower patient satisfaction. Outcomes suggested that suboptimal patient care and professional inefficiencies may be association with physician burnout. They recommend encouraging health-care organizations to invest in efforts to improve these core and complementary facets of their function.

Methods

• Using combinations of the key terms (physicians, burnout, and patient care), researchers performed detailed standardized searches of MEDLINE, EMBASE, PsycInfo, and CINAHL databases, without language restrictions, until October 22, 2017 to identify and obtain relevant data from quantitative observational studies. They also hand-search the reference lists of eligible studies and other relevant systematic reviews.
• Data extraction and synthesis involved two independent reviewers.
• Subgroup and sensitivity analyses followed the main meta-analysis.
• Random-effects models were used to perform all analyses.
• They performed formal tests for heterogeneity (I²) and publication bias.
• The quantitative associations of burnout with patient safety, professionalism, and patient satisfaction, reported as odds ratios (ORs) with their 95% confidence intervals (CIs), were the core outcomes assessed.

Results

• Researchers identified 5,234 records, of which they included 47 studies on 42,473 physicians (25,059 [59.0%] men; median age, 38 years [range, 27-53 years]) in the meta-analysis.
• Findings revealed an association of physician burnout with 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 reduced patient satisfaction (OR, 2.28; 95% CI, 1.42-3.68).
• High heterogeneity and low to moderate study quality were evident.
• They observed that the links between burnout and low professionalism were greater in residents and early-career (≤ 5 years post residency) physicians vs middle- and late-career physicians (Cohen Q=7.27; P=0.003).
• The main results were found to be substantially affected by the reporting method of patient safety incidents and professionalism (physician-reported vs system-recorded; Cohen Q=8.14; P=0.007).