4.6 Article

Self-Valuation Challenges in the Culture and Practice of Medicine and Physician Well-being

Journal

MAYO CLINIC PROCEEDINGS
Volume 96, Issue 8, Pages 2123-2132

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.mayocp.2020.12.032

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The study found that physicians had lower self-valuation compared to workers in other fields, and adjusting for self-valuation eliminated the association between being a physician and higher risk for burnout. Further experimental design research is needed to determine the causal relationship between self-valuation and burnout, as well as the potential for intervention at individual, organizational, and professional culture levels.
Objective: To compare physicians with workers in other fields on measures of self-valuation (SV) and determine the effect of adjusting for SV on the relationship between being a physician and risk for burnout. Patients and Methods: A random sample of physicians from the American Medical Association Physician Masterfile and a probability sample from the general US population were used. Data were collected for this cross-sectional study between October 12, 2017 and March 15, 2018. Burnout was indicated by a score of 27 or higher on Emotional Exhaustion or 10 or higher on Depersonalization, using the Maslach Burnout Inventory. Self-valuation was measured with Self-valuation Scale items. Results: Physicians (248/832=29.8%) more than workers in other fields (1036/5182=20.0%) often or always felt more self-condemnation than self-encouragement to learn from the experience when they made a mistake. Physicians (435/832=52.3%) more than workers in other fields (771/5182=14.9%) often or always put off taking care of their own health due to time pressure. Physicians had greater odds of burnout before (odds ratio [OW , 1.51; 95% CI, 1.30 to 1.76) but not after adjusting for SV responses (OR, 0.93; 95% CI, 0.78 to 1.11). After adjustment for SV, work hours, sex, and age, physicians had lower odds of burnout than workers in other fields (OR, 0.82; 95% CI, 0.68 to 0.99). Conclusion: Self-valuation is lower in physicians compared with workers in other fields and adjusting for SV eliminated the association between being a physician and higher risk for burnout. Experimental design research is needed to determine whether the association of SV with burnout is causal and the degree to which SV is malleable to intervention at individual, organization, and professional culture levels. (C) 2021 Mayo Foundation for Medical Education and Research

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