Burnout in Rheumatologists in Latin America

Abstract

Background: Rheumatology is considered a low-risk specialty, but studies have shown a prevalence of burnout between 42% and 51%. Objectives:The aim was to determine the prevalence of burnout in rheumatologists in Latin America and the factors associated with it.Methods: Cross-sectional study based on a survey completed through Google Forms platform that was sent by the national rheumatology associations of Latin America. Burnout was assessed with the Maslach Burnout Inventory. Data were analyzed using the statistical program SPSS v.22.Results: Two hundred ninety-seven rheumatologists from 15 countries were included, mainly Argentina (28.3%), Brazil (26.3%), and Mexico (12.8%). The majority were women 62%, 42.4% worked in public hospitals with an average of 40.1 ± 14.2 hours per week; 31.3% did research, 13.1% clinical trials, 56.6% teaching, and 42.8% administrative work; 36% received an annual income less than $25,000; 56.6% had burnout in at least 1 dimension. Only 20.2% thought they had burnout, 9.1% were currently receiving professional help, and 15.8% had sought help in the past; 72.1% said they were willing to participate in a program to reduce burnout. The rheumatologists with burnout were younger than those without burnout (46.5 vs 49.9 years, p = 0.015). Conclusions: Burnout affects near half of rheumatologists in LatinAmerica and was associated with younger age, long working hours, low satisfaction, less happiness, higher Patient Health Questionnaire-9, suicidal thoughts, anxiety, income, presence of comorbidities, and low self-esteem.

The Association of Grit With Burnout Components (Professional Efficacy, Exhaustion, and Cynicism) Among Academic Rheumatologists

“…It showed that, at the time of our survey, approximately 68% of the rheumatologists studied had at least 1 burnout symptom, 3.9% had exhaustion, 19.6% had cynicism, and 54.9% had low professional efficacy. These findings support recent reports that more than 50% of rheumatologists are experiencing burnout 1,3 . The results of a multivariate regression analysis suggested that higher grit was significantly associated with higher professional efficacy.…”

“…22 Academic rheumatologists' treatment of intractable chronic diseases requires engagement in long-term physician-patient relationships, and, in conjunction with this, they also experience pressure to perform successful research (a key requisite for tenure) and have uncertainty regarding their career progression. [2][3][4] This underlines the importance of professional efficacy for such professionals. Although the impact of grit on burnout should be carefully considered, as the concept of grit becomes more keenly defined, it is possible that academic rheumatologists with higher grit are better able to attribute positive meaning to difficult tasks and, as a result, complete tasks they start and maintain professional efficacy.…”

“…These findings support recent reports that more than 50% of rheumatologists are experiencing burnout. 1,3 The results of a multivariate regression analysis suggested that higher grit was significantly associated with higher professional efficacy.…”

“…Potential confounders, determined based on the findings from previous studies and clinical perspectives of rheumatologists, were as follows: (1) age at the time of the survey, 3,[13][14][15] (2) sex, 13,15 (3) marital status, 2 (4) having children, 16 and (5) job title. 14 Directed acyclic graphs were developed using DAGitty (version 3.0).…”

“…Previous studies have highlighted dissatisfaction with rheumatology practice 3 and excessive administrative tasks 2 as working-environment factors that are potentially related to burnout among rheumatologists. Pressure to perform successful research, a key requisite for tenure, 4 and uncertainty regarding one's career progression may also contribute to burnout 2 .…”