Dr. Barry Rubin
Dr. Barry Rubin, Chair and Medical Director of the Peter Munk Cardiac Centre at UHN, and lead author of published studies on clinician burnout. (Photo: UHN)

You can't always see it, but behind the polite smiles and disciplined demeanor, there lies a troubling reality. A potential danger to careers, to personal lives, and to patient care.

More than half the clinicians surveyed at the Peter Munk Cardiac Centre reported distress and burnout according to a series of studies published January 12 in the Canadian Medical Association Journal Open (CMAJ-OPEN). In these studies, carried out before the COVID-19 pandemic, 78 per cent of nurses, 73 per cent of allied health staff and 65 per cent of physicians described experiencing burnout.

"In my 35 years as a physician I have never seen a more serious issue for clinicians than burnout," says lead author Dr. Barry Rubin, Chair and Medical Director of the Peter Munk Cardiac Centre at UHN.

Completed in 2019, the study used the Well-Being Index, a survey tool developed by the Mayo Clinic, a globally recognized academic medical centre. A total of 414 physicians, nurses and allied health staff answered a series of questions about the level of stress they experienced in the previous month.

The index measured fatigue, depressions, burnout, anxiety or stress, mental and physical quality of life, work-life integration, meaning in work and distress. The study also evaluated the respondent's perception of adequacy of staffing levels, and of fair treatment in the workplace.

The results were then compared to outcomes for corresponding healthcare professionals at academic health science centres in the United States.

"Our staff are our most precious and valuable resource," says Leanna Graham, Director of Professional Practice and Policy at Toronto General Hospital and Co-Primary Investigator of the study. "Supporting each other and providing resources to enable wellness is paramount to achieving UHN's vision of A Healthier World.

"I expected reports of burnout in certain areas, and in some groups, but the extent reported was not what I expected."

Leanna Graham
Leanna Graham, Director of Professional Practice and Policy at Toronto General Hospital and Co-Primary Investigator of the study, says she was surprised by the extent of the burnout reported. (Photo: UHN)

Main findings and impact of the study:

  • 78 per cent of nurses, 73 per cent of allied health staff and 65 per cent of physicians described burnout in the month prior to when the survey was administered
  • 79 per cent of nurses, 56 per cent of allied health staff and 55 per cent of physicians had high levels of distress
  • Lower levels of distress among all clinicians were associated with a perception of fair treatment at work and a perception of adequate staffing levels

The impact of burnout on clinicians can include extreme fatigue, professional dissatisfaction, job turnover, decreased quality of life and thoughts of suicide.

"Burnout also has a negative impact on the care we provide," says Dr. Rubin. "It is associated with an increased incidence of medical errors, serious, safety events, readmission to hospital, worse patient outcomes and in some situations even increased patient mortality.

"Clinician burnout is a public health crisis that we must address now."  

What's next

The findings of these studies are the first step in acknowledging the existence, depth, and degree of distress and burnout among clinicians at the Peter Munk Cardiac Centre.

"Our next steps will be to meet with nurses, doctors and allied health staff, so that we can understand the key drivers of burnout in the PMCC and develop intervention strategies," says Dr. Rubin. "It is critical we address these issues and work together to bring about much-needed change.

"Healthcare workers give their all to care for others, it's time they are cared for too."

These studies were funded by the Peter Munk Cardiac Centre Innovation Fund.

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