Introduction

Physician burnout is linked to decreased job performance as well as increased medical errors, interpersonal conflicts and depression. Two recent multi-specialty studies showed that compared to other physicians in the 29-65 age group, urologists had the highest rate of burnout (54.4% vs. 63.6%); however, these reports were limited by a low sample size for urologists (n=119). We aimed to establish the prevalence of urologist burnout and to determine factors associated with burnout more comprehensively.

Methods

In the 2016 AUA Census, Maslach Burnout Inventory (MBI) questions were randomly assigned to half of the respondents. Using matrix sampling, the 1,126 practicing urologists who received and answered the MBI questions represent the entire 2,301 who completed the Census with a sampling weight of 2.04. Burnout was defined as scoring high in either the emotional exhaustion (score≥27) or depersonalization (score≥10) categories. Demographic and practice variables were assessed through both univariate descriptive analysis and multivariate logistic analysis to establish correlating factors to burnout.

Results

Overall, 38.8% of urologists met the criteria for burnout, of whom 17.2% scored high for emotional exhaustion and 37.1% scored high for depersonalization. Multivariate analysis revealed that urologist burnout is associated with a variety of factors as follows (ranked from most important): greater number of patient visits in a typical week; younger age group; in sub-specialty area other than pediatric or oncology; in either solo or multi-specialty practices; practice size of more than 2; and greater number of work hours in a typical week. (See table.)

Conclusions

These results suggest that the burnout rate for urologists, 38.8% overall or 41.3% in urologists ages 29-65, is lower than previously reported and is consistent with rates reported in other medical and surgical specialties. Burnout continues to be an important issue for urologists. Higher workload correlated with increased burnout while other practice patterns, such as being a solo owner of a practice or working in an academic center, appear to be protective. Understanding the causes of burnout in urology will help guide future intervention. It is important to keep all urologists in the workforce to help lessen projected shortages.

Funding

none