Impact of leadership behaviour on physician well-being, burnout, professional fulfilment and intent to leave: a multicentre cross-sectional survey study

Abstract

ObjectiveTo examine how perceived leadership behaviours affect burnout, professional fulfilment and intent to leave the organisation among physicians.DesignAnonymous cross-sectional survey study from November 2016 to October 2018.Setting12 036 attending and resident physicians at 11 healthcare organisations participating in the Physician Wellness Academic Consortium (PWAC) were surveyed to assess burnout and professional fulfilment and their drivers.ParticipantsA sample of 5416 attending physicians with complete data on gender, specialty, leadership, burnout and professional fulfilment.Main outcomes and measuresThe leadership behaviour of each physician’s supervisor was assessed using the Mayo Clinic Participatory Management Leadership Index and categorised in tertiles. Multivariable logistic regression analyses examined the effect of leadership behaviour rating of each physician’s supervisor on burnout, professional fulfilment and intent to leave controlling for gender and specialty.ResultsThe response rate was 45% across 11 institutions. Half of the respondents were female. Professional fulfilment increased with increasing tertiles of leadership behaviour rating (19%, 34%, 47%, p<0.001). The odds of professional fulfilment were 5.8 times higher (OR=5.8, 95% CI: 5.1 to 6.59) for physicians in the top tertile compared with those in the lowest tertile. Physicians in the top tertile were also 48% less likely to be burned out (OR=0.52, 95% CI: 0.45 to 0.61) and reported 66% lower intent to leave (OR=0.34, 95% CI: 0.26 to 0.44). Individuals who rated their supervisor’s leadership in upper tertiles relative to lower tertiles exhibited lower levels of burnout (18% vs 35% vs 47%, p<0.001), and intent to leave (16% vs 24% vs 50% p<0.001).ConclusionPerceived leadership behaviours have a strong relationship with burnout, professional fulfilment and intent to leave among physicians. Organisations should consider leadership development as a potential vehicle to improve physician wellness and prevent costly physician departures.

High cost of broken relationships

“…Physicians who rank their immediate supervisor higher on attributes such as 'is interested in my opinion' and 'encourages me to develop my skills and talents' have a 66% lower odds of intending to leave their current practice. 18 Feeling valued by one's organisation reduces the odds of intending to reduce clinical work by 35% and of intending to leave by 60%. 19 A move away from a physician-centric model of care to a team-centric model with strong staff support and task sharing allows the highest trained professionals to focus on the 'solution shop' work of solving unstructured problems and relationship building for which they are trained, and empower support staff to manage much of the standardised predictable work of the practice.…”

“…Relationships between physicians and their leaders also matter. Physicians who rank their immediate supervisor higher on attributes such as ‘is interested in my opinion’ and ‘encourages me to develop my skills and talents’ have a 66% lower odds of intending to leave their current practice 18. Feeling valued by one’s organisation reduces the odds of intending to reduce clinical work by 35% and of intending to leave by 60% 19…”

Reliability and validity of the Japanese version of the Professional Fulfillment Index among healthcare professionals: A validation study

“…One of the main characteristics of the PFI is that it expands the assessment of the perception of personal fulfillment through the evaluation of components intrinsic to aspects of physicians' work, such as happiness, meaning, self‐esteem, and satisfaction. The validity, sensitivity, and reliability of the original English version of the PFI have been established, 15 and it is widely used internationally to measure professional fulfillment and burnout 17,18 . As a scale for languages other than English, the Brazilian Portuguese version has also been validated 19 .…”

Strategies and Interventions to Improve Healthcare Professionals’ Well-Being and Reduce Burnout

“…20 Additionally, doctors who rated their supervisor's 1178641J PCXXX10.1177/21501319231178641Journal of Primary Care & Community HealthRazai et al letter2023 1 St George's University of London, London, UK 2 West London NHS Foundation Trust, London, UK 3 Imperial College London, London, UK leadership behavior highly showed lower levels of burnout, intention to leave their job, and higher levels of professional fulfilment. 21 Supportive colleagues and healthcare managers can have a significant impact on healthcare workers' wellbeing. Group activities and discussions can be helpful if staff feel the leadership is approachable, supportive, and responsive to their needs and concerns.…”

“… 20 Additionally, doctors who rated their supervisor’s leadership behavior highly showed lower levels of burnout, intention to leave their job, and higher levels of professional fulfilment. 21 Supportive colleagues and healthcare managers can have a significant impact on healthcare workers’ well-being. Group activities and discussions can be helpful if staff feel the leadership is approachable, supportive, and responsive to their needs and concerns.…”