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- Page navigation anchor for RE: Lower Likelihood of Burnout Among Family Physicians From Underrepresented Racial-Ethnic GroupsRE: Lower Likelihood of Burnout Among Family Physicians From Underrepresented Racial-Ethnic Groups
In “Lower Likelihood of Burnout Among Family Physicians From Underrepresented Racial-Ethnic Groups'', Douglas et al determined that underrepresented individuals in medicine (UiM) were less likely to experience burnout.1 These findings are in stark contrast to overwhelming evidence of racial discrimination and stereotyping correlating to greater distress and depression scores among UiM. Douglas et al analyzed responses on an examination questionnaire regarding emotional exhaustion and depersonalization. To support their methods, they rationalized that emotional exhaustion and depersonalization are valid predictors of burnout on the Maslach Burnout Inventory (MBI). However, the MBI has multiple shortcomings including a lack of validation in UiM.2 This approach likely resulted in inaccurate findings and grossly under-reported physician burnout in an especially vulnerable and marginalized population.
The MBI assesses burnout using three subscales: emotional exhaustion, depersonalization, and reduced personal accomplishment.3 Several limitations, however, have been previously identified with the MBI. These limitations include using only negative wording to frame emotional exhaustion and depersonalization2 along with an unclear clear relationship between the concept of burnout and how it is measured.3 The MBI defines burnout using all three subscales but also states that each of these must be evaluated independently. The MBI’s most important limitation, however,...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: Lower LIkelihood of Burnout Among Family Physicians From Underrepresented Racial-Ethnic GroupsRE: Lower LIkelihood of Burnout Among Family Physicians From Underrepresented Racial-Ethnic Groups
Lower Likelihood of Burnout Among Racial and Ethnic Minority Family Physicians
A Commentary
Jeannette E. South-Paul, MD, DHL (Hon), FAAFP
8 3 2021Douglas and colleagues’ recently completed a cross-over observational survey of applicants from the 2017 American Board of Family Medicine recertification exam and those responding to the 2017 National Graduate survey. They noted a lower likelihood of burnout among family physicians from underrepresented racial-ethnic groups. They used structural equation models to test the effects of underrepresented status on measures of emotional exhaustion and depersonalization. Family physicians underrepresented in medicine were significantly less likely than their non-underrepresented counterparts to report emotional exhaustion and depersonalization, to practice in more racially and ethnically diverse counties and to practice obstetrics.
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Studies such as this must focus on the data that are available and associated with the study participants. Nonetheless, professional factors influencing individual physician experiences necessarily layer upon personal characteristics and environment as well as historical experiences which are not available in databases. The epidemic of burnout among health care professionals has prompted ongoing analysis of these factors in the hope of interrupting the stressors that have devastated not only individual practitioners but their colleagues and the patients for whom they care....Competing Interests: None declared. - Page navigation anchor for RE: Finding the aspects of caring that make family doctors happyRE: Finding the aspects of caring that make family doctors happy
The article by Douglas et.al. is an important contribution to what must be an ongoing search in family medicine to identify factors which are likely to contribute to satisfaction and a positive spirit in family physicians.
Medicine is about service - to patients and communities. This study, not surprisingly to many of us, finds that family physicians from underrepresented groups in society have a more positive attitude about their work - and coincidentally, their work is often in more challenging communities. Three quarters of a century ago, the Psychiatrist Robert Coles in his landmark five volume series Children of Crisis (Little Brown and Co Publisher) focused on how children subjected to dire conditions of poverty, racism and general deprivation managed to surmount those challenges and go on to successful adulthood and lives of service. Supportive family members, teachers, and adults were critical to children finding resilience.
My suspicion is that, when the next stage of the research by Montgomery and his colleagues gets underway to find out why and how the family physicians from underrepresented groups in their study find a more positive and satisfying life's work, they may find some of the same factors as Coles did with children. A sense of purpose, service and positive contribution to communities that many family physicians feel will add to that resilience and, I hope, sustain the discipline and inspire more young people to lives caring for th...
Show MoreCompeting Interests: None declared.