Objective Burnout among physicians is common and has important implications. We assessed the extent of burnout among rheumatology practitioners and its associations. Methods 128 attendees at the 2019 Rheumatology Winter Clinical Symposium were surveyed using the Maslach Burnout Index™ (MBI™) and a demographics questionnaire. Scores for emotional exhaustion (EE) ≥27, depersonalization (DP) ≥10, and personal accomplishment (PA) ≤33 were considered positive for burnout. Data regarding practitioner characteristics including age, sex, years in practice, and other demographics of interest were also collected. These data were used to determine prevalence and interactions of interest between practitioner characteristics and the risk of burnout. Results Of the 128 respondents, 50.8% demonstrated burnout in at least one MBI™ domain. Dissatisfaction with EMR was associated with a 2.86 times increased likelihood of burnout (OR=2.86 p=0.015, 95% CI: 1.23-6.65). Similar results were found for lack of exercise (OR=5.00 p= 0.016, 95% CI: 1.3 - 18.5) and work hours > 60 hour/week (OR=2.6 p= 0.019, 95% CI: 1.16 - 5.6). Practitioners in group practice were 57% less likely to burnout (OR=0.43 p=0.029 95% CI: 0.20-0.92), as were those who spend > 20% of their time in personally satisfying work (OR=0.32 p=0.005 95% CI: 0.15-0.71). Conclusion In what we believe to be one of the largest studies regarding burnout among rheumatology practitioners, we found a substantial prevalence of burnout, with 51% of all respondents meeting criteria in at least one domain defined by the MBI™ and 54% of physicians meeting this same criterion.

Physicians who received their medical training outside the United States constitute a substantial proportion of the physician workforce in states with a high burden of COVID-19 cases and deaths. As described in this essay, immigrant physicians and their families also may be especially vulnerable because of several circumstances that relate to their visa status.

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