Harmful dimensions of medical culture in relation to physician burnout: A cross-sectional study

Banse, Emilie Mikolajczak, Moïra Bayot, Marie Lenoir, Anne-Laure de Timary, Philippe

Physician burnout (PB) is an emotional exhaustion in response to long-term workplace stress. Despite growing interest in how the medical culture contributes to physician burnout, there is little empirical research on the subject. In this study, we aimed to evaluate quantitatively specific dimensions of the medical culture, thereby testing the hypothesis that a group of interdependent aspects of medical culture would positively correlate with PB. We collected on-line survey results in a cross-sectional study of 1002 physicians in current clinical practice. Participants completed the Burnout Assessment Tool and additional survey items measuring aspects of contemporary medical culture. Using exploratory and confirmatory factor analyses, we first explored and confirmed the factorial validity of a model representing the medical cultural dimensions, and then undertook regression analyses to investigate their associations with physician burnout. The analyses revealed seven relevant factors of the medical culture clustering in three distinct but interdependent broader dimensions, which we designated as (1) Physician’s Professional Commitment, (2) The Myth of the Invulnerable Physician, and (3) Physician Stigma towards Burnout. These three dimensions had independent associations with increased burnout, suggesting that they are detrimental to the welfare of physicians. Additionally, we identified a specific factor reflecting the Existential Significance of Being a Physician, which mitigated against burnout. Upon controlling for sociodemographic and professional characteristics, the investigated dimensions of medical culture accounted for 30% of the variance in PB. This quantitative exploration of the relations between medical culture and physician defined dimensions of medical cultural that are harmful to physicians and by extension to patient care. Present results highlight the need for further empirical investigations of medical culture and the pathways whereby certain dimensions of medical culture specifically relate to the well-being and health of physicians.