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JU INSIGHT: Burnout: A Call to Action From the AUA Workforce Workgroup

By: Andrew M. Harris, MD, University of Kentucky Medical Center, Lexington, Lexington VA Medical Center, Kentucky; Seth Teplitsky, MD, University of Kentucky Medical Center, Lexington; Kate H. Kraft, MD, University of Michigan, Ann Arbor; Raymond Fang, MSc, MASc, American Urological Association, Linthicum, Maryland; William Meeks, MA American Urological Association, Linthicum, Maryland; Amanda North, MD, Montefiore Medical Center, Bronx, New York | Posted on: 17 Mar 2023

Harris AM, Teplitsky S, Kraft KH, Fang R, Meeks W, North A. Burnout: a call to action from the AUA Workforce Workgroup. J Urol. 2023;209(3):573-579.

Study Need and Importance

The AUA Workforce Workgroup appreciates the opportunity to continue studying the well-being of our members. Burnout has been a topic of tremendous importance since we first analyzed the issue in 2016. Burnout is associated with lower patient satisfaction scores, worse patient outcomes, increased risk of adverse events, worse personal health, depression, and suicide.

What We Found

When examining the AUA Census respondents in total, there has been minimal change over the past 5 years. Concerningly, when examined by demographics, a different story comes to light. Burnout in women has increased substantially, from 35.3% to 49.2%, and remained similar in men, at 36.3% to 35.2% (see Figure). Those urologists under the age of 45 also had substantial increases in burnout, from 37.9% to 44.8%. Further, urologists from 45-54 years old also had increased burnout, from 43.4% to 44.6%. While mid-career physicians have typically had the highest rates of burnout, this new finding of high burnout in the early-career group is especially concerning as it could lead to career change and subsequent workforce shortages. Regarding gender discrepancy, women were more likely to resolve conflict in favor of work responsibilities than men, at 33% vs 18%. Regarding work-life balance, women were more likely to be dissatisfied or very dissatisfied than men, at 37.1% vs 22.5%. Compared to men, women were more likely to report their work schedule doesn’t leave enough time for personal and/or family life, at 57.5% vs 33.6%.

Figure. Percent of respondents who reported burnout from the 2016 and 2021 AUA Census, comparing across genders. The error bars represent upper and lower 95% confidence intervals.

Limitations

The study has limitations seen in survey work, including sampling and recall bias.

Interpretation

Younger urologists and women urologists experienced higher burnout in 2021 when compared to 2016. Burnout is dangerous as well as costly for our members and patients. The importance of appropriate mitigation should not be underestimated. Prevention of burnout is conceptually straightforward but has proved to be difficult to achieve. The decisions to combat burnout must be made from those in leadership positions at both the local and the policy levels, which requires an understanding of burnout as well as a motivation for change. We should strongly consider the opportunity to support our colleagues who are suffering.

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