Burnout in Chairs of Academic Departments of Ophthalmology

doi:10.1016/j.ophtha.2007.04.058

Ophthalmology

Volume 114, Issue 12, December 2007, Pages 2350-2355.e1

Presented at: Association of University Professors of Ophthalmology 40th Annual Meeting, January 2006, Sarasota, Florida.

https://doi.org/10.1016/j.ophtha.2007.04.058 Get rights and content

Purpose

To evaluate the incidence of burnout in chairs of academic departments of ophthalmology, identify stressors, and propose methods for reducing and preventing burnout in our academic leaders.

Design

Cross-sectional study.

Participants

One-hundred thirty-one chairs of academic departments of ophthalmology in the United States and Canada.

Methods

Confidential surveys mailed to ophthalmology chairs.

Main Outcome Measures

Questionnaires assessed demographics, potential stressors, satisfaction with personal life, self-efficacy, burnout as measured by the Maslach Burnout Inventory–Human Services Survey (MBI-HSS), and quality of life.

Results

Questionnaires were returned from 101 chairs, a response rate of 77%. Each chair had served an average of 9.4 years. They worked an average of 62 hours each week, spending 41% on patient care, 36% on administrative duties, 13% on teaching, and 9% on research. There was no difference in hours worked each week in chairs who had served >10 years from those who had been chair <5 years. The most frequently identified stressors were faculty retention, Residency Review Committee/Accreditation Council for Graduate Medical Education issues, department or hospital budgets, and compliance issues. Seventy percent of chairs reported they are currently satisfied with their positions compared with 79% who reported feeling that way 5 years ago. Nine chairs (9%) were considered to have burnout based on their MBI-HSS surveys, and 9 (9%) chair’s scores showed no characteristics of burnout. Fifty-six percent had scores consistent with low personal achievement, the highest risk factor for burnout. Overall, the MBI-HSS revealed moderate subscale scores for emotional exhaustion, low for depersonalization, and low for personal accomplishment.

Conclusions

The overall prevalence of burnout in chairs of academic departments of ophthalmology is similar to burnout rates seen in chairs of other academic departments. The MBI-HSS scores for ophthalmology chairs showed high levels of emotional exhaustion, moderate levels of depersonalization, and moderate levels of personal accomplishment. Because the cost of burnout can be high, both in terms of a chair’s psychological well-being and the actual cost associated with replacing a chair, it is important that strategies are put in place to reduce burnout in our academic leaders.

Section snippets

Materials and Methods

After receiving institutional review board approval, a cross-sectional questionnaire-based study was performed on 131 chairs of academic departments of ophthalmology in the United States and Canada. The mailing list was developed by review of the 2004/2005 Directory of the Association of University Professors of Ophthalmology (AUPO), and through direct inquiry. The questionnaires, approved by the AUPO, were confidential. A letter of verification was distributed along with a letter accompanying

Demographics

One-hundred one completed surveys were returned, a response rate of 77%. Ninety-four percent of the respondents held permanent appointments. Demographic and descriptive data for the departments are summarized in Table 1. Ninety-seven percent (98/101) of respondents were male, and 3% (3/101) were female. Six percent (6/101) were interim chairs. There was no difference in burnout for chairs who had served for >10 years compared with chairs who had served <5 years. The number of hours worked per

Discussion

In evaluating the incidence of burnout in chairs of academic departments of obstetrics and gynecology, Gabbe et al¹⁰ found burnout to be present in 4% of respondents to their survey with no evidence of burnout identified in 8%. The chairs identified hospital and departmental budget deficits, Medicare and Medicaid billing audits, loss of key faculty, union disputes, and faculty, resident, and staff dismissals as their most significant stressors. To cope with stress, these chairs reported

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Burnout syndrome (BOS) affects all professional categories, particularly in the medical sector. Perceived deterioration of working conditions in university hospital centres impacts not only hospital doctors, but also and more generally, university hospital (UH) staff. The goal of this survey was to analyse workplace quality of life among French UH digestive surgeons.
An online questionnaire was addressed to all members of sub-section 52-02 (digestive and visceral surgery) of the national university council (CNU). It contained isolated questions, as well as the specific Copenhagen Burnout Inventory (CBI) questionnaire, which assesses three fields: personal burnout (PBO), work-related burnout (WBO) and client-related burnout (CBO).
While 132 (85%) out of the 156 surgeons responded, only 110 (70%) filled out the CBI questionnaire. Their perceptions of quality of life were poor or very poor (57%), and progressively poorer; this was mainly due to a lack of human, logistical and financial means, and also to conflictual relations with administration. The CBI questionnaire showed high scores for PBO (37%) and WBO (30%), with lower scores for CBO (8%). Depressive syndrome appeared among 26% of respondents. There were no significant differences according to region, gender or age.
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The MBI-HSS provides subscale scores for the 3 domains of burnout: emotional exhaustion, depersonalization, and personal accomplishment (10). High burnout has been defined as coexistence of high emotional exhaustion score (score of ≥27 on the emotional exhaustion subscale), high depersonalization score (score of ≥10 on the depersonalization subscale), and low personal accomplishment score (score of ≤33 on the personal accomplishment subscale) (11–15). However, it is known that physicians may experience burnout, despite having a sense of high personal accomplishment; several studies have reported burnout in physicians manifesting as high emotional exhaustion and/or high depersonalization (16–20).
To assess the prevalence and associated factors of burnout among U.S. academic radiologists.
An online survey was sent to the radiologists who were full members of the Association of University Radiologists in December 2018. Burnout was measured using the abbreviated Maslach Burnout Inventory Human Services Survey. Survey respondents were also requested to complete questions on demographics, potential professional stressors, sense of calling, and career satisfaction. Associations between survey participants’ characteristics and burnout were tested using logistic regression model.
The survey response rate was 27% (228/831). Twenty-nine percent met all three criteria for high burnout, including high emotional exhaustion, high depersonalization, and low personal accomplishment. Seventy-nine percent had one or more symptoms of burnout.
Numerous factors including work overload, inability to balance personal and professional life, lack of autonomy, lack of appreciation from patients and other medical staff were significantly associated (p < 0.05) with high burnout. Older age (OR, 0.95; 95%CI 0.92–0.98; p < 0.05), higher number of years of experience practicing as radiologists (OR, 0.95; 95%CI 0.92–0.98; p < 0.05), and holding academic rank of professor (OR, 0.25; 95%CI 0.11–0.56; p < 0.05) were factors associated with lower odds of experiencing burnout.
Radiologists with high burnout were more likely to be dissatisfied with their career (OR, 2.28; 95%CI 1.70–3.07; p < 0.0001) and less likely to identify medicine as a calling.
Multiple factors contribute to high burnout in academic radiologists. Familiarity with these factors may help academic radiology departments to develop strategies to promote health and wellness of their faculty
A Call to Action – Our Radiology Chairs Are Burning Out
2019, Academic Radiology
Burnout in Chairs of Academic Radiology Departments in the United States
2019, Academic Radiology
Citation Excerpt :
The survey content was similar to that of other studies that evaluated burnout in academic department chairs in various surgical and medical subspecialties (7–12). To allow direct comparison to other studies and to determine if the trends observed in chairs of other departments would also apply to chairs of radiology departments, we designed our online cross-sectional survey to closely mirror the surveys used in other studies on this topic (7–12). The questionnaire was divided into four parts and included 39 questions.
We aimed to estimate the self-reported prevalence of burnout in chairs of academic radiology departments in the United States and identify factors associated with high burnout in chairs.
An anonymous cross-sectional online survey was conducted of members of the Society of Chairs of Academic Radiology Departments. Burnout was measured using the abbreviated Maslach Burnout Inventory Human Services Survey. Associations between survey participants’ characteristics and burnout were tested using Fisher's exact test and Wilcoxon rank sum test.
Of the 123 chairs invited to complete the survey, 87 responded (response rate, 71%). The mean age of the participants was 58 years. The survey respondents had an average of 9 years of experience as department chair. The average number of work hours per week was 62 hours. Four participants (5%) of the academic chairs met all three criteria for high burnout including high emotional exhaustion, high depersonalization, and low personal accomplishment. Thirty-three participants (38%) had high emotional exhaustion and/or high depersonalization score. Low professional satisfaction score, low work-life balance satisfaction score, and low chair effectiveness score were significantly associated with high burnout. High emotional exhaustion and/or high depersonalization were significantly associated with numerous professional stressors. Lack of an institutional support group for chairs and lower number of faculty members in the department were significantly associated with burnout.
A significant proportion of chairs of academic radiology departments are experiencing 1 or more symptoms of burnout. Efforts to address burnout in radiology chairs should be initiated promptly at the national, institutional, and departmental levels.
Chairs of United States Academic Ophthalmology Departments: A Descriptive Analysis and Trends
2018, American Journal of Ophthalmology
To characterize and analyze the profile of United States (US) academic ophthalmology department chairs.
Cross-sectional study.
Setting: Web search of publicly accessible sources. Study Population: One hundred and eleven US ophthalmology chairs. Main Outcome Measures: Demographic and academic data.
Of the 111 chairs reviewed, 90% are male. Mean age of chairs is 59 years, and mean age at time of appointment is 47 years. Ninety-two percent of chairs graduated from an American medical school. Twenty-eight percent of chairs also have additional graduate degrees: 8% a Doctor of Philosophy (PhD) degree, 15% a master's degree, and 5% both. Ninety-five percent of chairs completed a clinical fellowship, most frequently in cornea (25%), vitreoretinal surgery (23%), and glaucoma (21%). The 3 programs that trained the largest number of chairs are Massachusetts Eye and Ear Infirmary, Wilmer Eye Institute, and Bascom Palmer Eye Institute. Thirty-two percent of chairs were previously trained in the program they currently head, more commonly as a resident (28%) than as a fellow (5%). The estimated mean number of publications per chair is 108 (range, 0-850) and the mean h-index is 24. Twenty-seven programs exchanged chairs from 2014 to 2017. The characteristics of appointed chairs are no different than those of recently retired chairs.
Ophthalmology chairs remain predominately male, most often specializing in cornea, vitreoretinal surgery, or glaucoma. Most chairs tend to be prolific authors whose careers have placed an emphasis on research; however, a lack of demonstrated research experience does not preclude chairmanship in certain US programs.
Changes in the burnout profile of chairs of academic departments of obstetrics and gynecology over the past 15 years
2018, American Journal of Obstetrics and Gynecology
While many studies have documented the high prevalence of burnout in practicing physicians and medical trainees, fewer reports describe burnout in academic leaders. In 2002, we observed a moderate-high to high level of burnout in 41.4% of chairs of academic departments of obstetrics and gynecology.
The purpose of this study was to identify trends in burnout and associated factors in today’s obstetrics and gynecology chairs as they face complex changes to the current health care environment.
This was a cross-sectional study. A survey was developed based on the questionnaire used in our first investigation and sent electronically to all members of the Council of University Chairs of Obstetrics and Gynecology. Burnout was measured using an abbreviated Maslach Burnout Inventory-Human Sciences Survey. In addition to demographic data, we assessed perceived stressors, job satisfaction, spousal/partner support, self-efficacy, depression, suicidal ideation, and stress management.
The response rate was 60% (84/139). Almost 30% of chairs were women, increased from 7.6% in 2002. Hospital and department budget deficits and loss of key faculty remain major stressors noted by participants. The Maslach Burnout Inventory results have changed dramatically over the past 15 years. Today’s chairs demonstrated less burnout but with an “ineffective” profile. Subscale scores for emotional exhaustion and depersonalization were reduced but >50% reported low personal accomplishment. Spousal support remained important in preventing burnout.
Chairs of academic departments of obstetrics and gynecology continue to face significant job-related stress. Burnout has decreased; however, personal accomplishment scores have also declined most likely due to administrative factors that are beyond the chairs’ perceived control.

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Manuscript no. 2007-222.

Supported in part by an unrestricted departmental grant from Research to Prevent Blindness, Inc., New York, New York, to Saint Louis University Department of Ophthalmology.

The authors have no financial or proprietary interest in the information presented.

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Original articleBurnout in Chairs of Academic Departments of Ophthalmology

Purpose

Design

Participants

Methods

Main Outcome Measures

Results

Conclusions

Section snippets

Materials and Methods

Demographics

Discussion

J Emerg Med

Am J Obstet Gynecol

Am J Obstet Gyencol

Maslach Burnout Inventory: Manual

Job burnout

Annu Rev Psychol

A Burnt-out Case

Maslach Burnout Inventory: Manual

Maslach Burnout Inventory: Manual

Burnout and career-choice regret among family practice physicians in early practice

Fam Pract Res J

Burnout among American surgeons

Surgery

Mid-career burnout in generalist and specialist physicians

JAMA

Burnout in academic chairs of otolaryngology: head and neck surgery

Laryngoscope

Original article
Burnout in Chairs of Academic Departments of Ophthalmology