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Mistreatment Experiences, Protective Workplace Systems, and Occupational Distress in Physicians

IMPORTANCE: Reducing physician occupational distress requires understanding workplace mistreatment, its relationship to occupational well-being, and how mistreatment differentially impacts physicians of diverse identities. OBJECTIVES: To assess the prevalence and sources of mistreatment among physic...

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Autores principales: Rowe, Susannah G., Stewart, Miriam T., Van Horne, Sam, Pierre, Cassandra, Wang, Hanhan, Manukyan, Makaila, Bair-Merritt, Megan, Lee-Parritz, Aviva, Rowe, Mary P., Shanafelt, Tait, Trockel, Mickey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077480/
https://www.ncbi.nlm.nih.gov/pubmed/35522279
http://dx.doi.org/10.1001/jamanetworkopen.2022.10768
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author Rowe, Susannah G.
Stewart, Miriam T.
Van Horne, Sam
Pierre, Cassandra
Wang, Hanhan
Manukyan, Makaila
Bair-Merritt, Megan
Lee-Parritz, Aviva
Rowe, Mary P.
Shanafelt, Tait
Trockel, Mickey
author_facet Rowe, Susannah G.
Stewart, Miriam T.
Van Horne, Sam
Pierre, Cassandra
Wang, Hanhan
Manukyan, Makaila
Bair-Merritt, Megan
Lee-Parritz, Aviva
Rowe, Mary P.
Shanafelt, Tait
Trockel, Mickey
author_sort Rowe, Susannah G.
collection PubMed
description IMPORTANCE: Reducing physician occupational distress requires understanding workplace mistreatment, its relationship to occupational well-being, and how mistreatment differentially impacts physicians of diverse identities. OBJECTIVES: To assess the prevalence and sources of mistreatment among physicians and associations between mistreatment, occupational well-being, and physicians’ perceptions of protective workplace systems. DESIGN, SETTING, AND PARTICIPANTS: This survey study was administered in September and October 2020 to physicians at a large academic medical center. Statistical analysis was performed from May 2021 to February 2022. MAIN OUTCOMES AND MEASURES: Primary measures were the Professional Fulfillment Index, a measure of intent to leave, and the Mistreatment, Protection, and Respect Measure (MPR). Main outcomes were the prevalence and sources of mistreatment. Secondary outcomes were the associations of mistreatment and perceptions of protective workplace systems with occupational well-being. RESULTS: Of 1909 medical staff invited, 1505 (78.8%) completed the survey. Among respondents, 735 (48.8%) were women, 627 (47.1%) were men, and 143 (9.5%) did not share gender identity or chose “other”; 12 (0.8%) identified as African American or Black, 392 (26%) as Asian, 10 (0.7%) as multiracial, 736 (48.9%) as White, 63 (4.2%) as other, and 292 (19.4%) did not share race or ethnicity. Of the 1397 respondents who answered mistreatment questions, 327 (23.4%) reported experiencing mistreatment in the last 12 months. Patients and visitors were the most common source of mistreatment, reported by 232 physicians (16.6%). Women were more than twice as likely as men to experience mistreatment (31% [224 women] vs 15% [92 men]). On a scale of 0 to 10, mistreatment was associated with a 1.13 point increase in burnout (95% CI, 0.89 to 1.36), a 0.99-point decrease in professional fulfillment (95% CI, −1.24 to −0.73), and 129% higher odds of moderate or greater intent to leave (odds ratio, 2.29; 95% CI, 1.75 to 2.99). When compared with a perception that protective workplace systems are in place “to a very great extent,” a perception that there are no protective workplace systems was associated with a 2.41-point increase in burnout (95% CI, 1.80 to 3.02), a 2.81-point lower professional fulfillment score (95% CI, −3.44 to −2.18), and 711% higher odds of intending to leave (odds ratio, 8.11; 95% CI, 3.67 to 18.35). CONCLUSIONS AND RELEVANCE: This survey study found that mistreatment was common among physicians, varied by gender, and was associated with occupational distress. Patients and visitors were the most frequent source, and perceptions of protective workplace systems were associated with better occupational well-being. These findings suggest that health care organizations should prioritize reducing workplace mistreatment.
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spelling pubmed-90774802022-05-24 Mistreatment Experiences, Protective Workplace Systems, and Occupational Distress in Physicians Rowe, Susannah G. Stewart, Miriam T. Van Horne, Sam Pierre, Cassandra Wang, Hanhan Manukyan, Makaila Bair-Merritt, Megan Lee-Parritz, Aviva Rowe, Mary P. Shanafelt, Tait Trockel, Mickey JAMA Netw Open Original Investigation IMPORTANCE: Reducing physician occupational distress requires understanding workplace mistreatment, its relationship to occupational well-being, and how mistreatment differentially impacts physicians of diverse identities. OBJECTIVES: To assess the prevalence and sources of mistreatment among physicians and associations between mistreatment, occupational well-being, and physicians’ perceptions of protective workplace systems. DESIGN, SETTING, AND PARTICIPANTS: This survey study was administered in September and October 2020 to physicians at a large academic medical center. Statistical analysis was performed from May 2021 to February 2022. MAIN OUTCOMES AND MEASURES: Primary measures were the Professional Fulfillment Index, a measure of intent to leave, and the Mistreatment, Protection, and Respect Measure (MPR). Main outcomes were the prevalence and sources of mistreatment. Secondary outcomes were the associations of mistreatment and perceptions of protective workplace systems with occupational well-being. RESULTS: Of 1909 medical staff invited, 1505 (78.8%) completed the survey. Among respondents, 735 (48.8%) were women, 627 (47.1%) were men, and 143 (9.5%) did not share gender identity or chose “other”; 12 (0.8%) identified as African American or Black, 392 (26%) as Asian, 10 (0.7%) as multiracial, 736 (48.9%) as White, 63 (4.2%) as other, and 292 (19.4%) did not share race or ethnicity. Of the 1397 respondents who answered mistreatment questions, 327 (23.4%) reported experiencing mistreatment in the last 12 months. Patients and visitors were the most common source of mistreatment, reported by 232 physicians (16.6%). Women were more than twice as likely as men to experience mistreatment (31% [224 women] vs 15% [92 men]). On a scale of 0 to 10, mistreatment was associated with a 1.13 point increase in burnout (95% CI, 0.89 to 1.36), a 0.99-point decrease in professional fulfillment (95% CI, −1.24 to −0.73), and 129% higher odds of moderate or greater intent to leave (odds ratio, 2.29; 95% CI, 1.75 to 2.99). When compared with a perception that protective workplace systems are in place “to a very great extent,” a perception that there are no protective workplace systems was associated with a 2.41-point increase in burnout (95% CI, 1.80 to 3.02), a 2.81-point lower professional fulfillment score (95% CI, −3.44 to −2.18), and 711% higher odds of intending to leave (odds ratio, 8.11; 95% CI, 3.67 to 18.35). CONCLUSIONS AND RELEVANCE: This survey study found that mistreatment was common among physicians, varied by gender, and was associated with occupational distress. Patients and visitors were the most frequent source, and perceptions of protective workplace systems were associated with better occupational well-being. These findings suggest that health care organizations should prioritize reducing workplace mistreatment. American Medical Association 2022-05-06 /pmc/articles/PMC9077480/ /pubmed/35522279 http://dx.doi.org/10.1001/jamanetworkopen.2022.10768 Text en Copyright 2022 Rowe SG et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Rowe, Susannah G.
Stewart, Miriam T.
Van Horne, Sam
Pierre, Cassandra
Wang, Hanhan
Manukyan, Makaila
Bair-Merritt, Megan
Lee-Parritz, Aviva
Rowe, Mary P.
Shanafelt, Tait
Trockel, Mickey
Mistreatment Experiences, Protective Workplace Systems, and Occupational Distress in Physicians
title Mistreatment Experiences, Protective Workplace Systems, and Occupational Distress in Physicians
title_full Mistreatment Experiences, Protective Workplace Systems, and Occupational Distress in Physicians
title_fullStr Mistreatment Experiences, Protective Workplace Systems, and Occupational Distress in Physicians
title_full_unstemmed Mistreatment Experiences, Protective Workplace Systems, and Occupational Distress in Physicians
title_short Mistreatment Experiences, Protective Workplace Systems, and Occupational Distress in Physicians
title_sort mistreatment experiences, protective workplace systems, and occupational distress in physicians
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077480/
https://www.ncbi.nlm.nih.gov/pubmed/35522279
http://dx.doi.org/10.1001/jamanetworkopen.2022.10768
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