乌鸦传媒

TAMPA -- Doctors who specialize in pain medicine appear to be at greater risk of experiencing professional burnout than physicians in other specialties, researchers reported here.

"In other studies of specialty groups, 38% of all doctors experienced burnout," explained from Wayne State University School of Medicine in Detroit. "But in this survey, about 61% of pain specialists experienced burnout."

In a poster presentation by Kroll and colleagues at the annual scientific meeting of the American Pain Society, 230 doctors who completed the survey reported that in the realm of emotional exhaustion, 21.7% rated that factor as low, 16.9% said it was moderate, and 61.3% rated it as high.

For depersonalization, 30.8% rated it low, 34.5% rated it moderate, and 35.6% rated it high.

In terms of personal accomplishment, 42.6% considered it low, 36.5% considered it moderate, and 19.6% considered it high.

"The incidence of burnout amongst pain medicine physicians is significant and worrisome," Kroll's group wrote. "This occupational fatigue places them at great risk for alcohol use, interpersonal difficulties, suicidal ideation, and increases the risk for medical error."

He said that in three of the subscales used in the study, pain medicine doctors showed incidence of burnout higher than other specialties. "Additionally, our study reveals that elevated psychological demands in the workplace increase the prevalence of burnout," his group wrote, adding "research into interventions that mitigate these stressors needs to be developed."

Kroll's group sent validated questionnaires to the American Society of Interventional Pain Physicians from June 2013 to November 2013. The 33-questions in the survey were designed to illicit demographics and to assess job satisfaction through the Maslach Burnout Inventory-Human Service Survey and Job Content Questionnaire.

"We tried to figure out what was predictive of burnout," Kroll told 乌鸦传媒. "We observed that doctors were under pressure for high demand, yet they had low support and low control, all of which leads to job strain."

He said psychological demands were a significant predictor of burnout in the emotional exhaustion inventory (P<0. 01), while for depersonalization, psychological demands, and the specialty of pain medicine were significant predictors (P<0.01). There were no significant predictors for feelings of personal accomplishment or lack thereof.

Kroll pointed out that the survey was done just prior to the rollout of the Affordable Care Act (ACA) and physicians may have felt extra pressure at that time. Uncertainty about the ACA and lack of time and say in the implementation process could have placed "increased psychological demands on pain physicians," he said.

"This is a fairly significant area of concern," commented APS president. He pointed out that pain management can be a particularly difficult area of medicine.

"We don't often have dramatic effects on chronic pain," Fillingim, director of the UF Pain Research and Intervention Center of Excellence at the University of Florida in Gainesville, told 乌鸦传媒. "We have a patient population that is suffering greatly. We don't have ready-made interventions that reduce that suffering dramatically and quickly. That is frustrating."

"You put that together and you create a series of patient-provider interactions where the patients may be dissatisfied, the provider might be dissatisfied, and patients may have other comorbidities that are outside the [pain medicine] provider's purview. That is a pretty good formula for burnout," he added.

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