Part 1 | What the research says on burnout in podiatrists

Who are the authors/researchers?

Daniel R. Bonanno, Belinda G. O’Sullivan, Anna Couch, Terry Haines, Cylie M. Williams, and Hylton B. Menz.

 

What is the goal behind the research?

The goal of this research is to understand the factors associated with burnout in Australian podiatrists. By identifying these factors, we can develop better support systems for both individuals and businesses. Burnout is a concern familiar to every employee and employer. Data from other healthcare professions, like physiotherapy and physicians, suggest this is a widespread issue (1, 2, 3, 4, 5, 6)

 

What was this study’s aim?

The primary aim of this study was to determine if (i) individual characteristics, (ii) workplace factors, and (iii) job satisfaction measures are associated with burnout among Australian podiatrists.

 

What is already known on the topic?

• A recent study conducted in a Swiss hospital concluded findings from 1,840 employees:
  • One in twelve health professionals’ experiences increased burnout symptoms, with every sixth considering leaving the profession (3).
  • Work-life imbalance and effort-reward disparities are the strongest predictors of burnout symptoms and thoughts of leaving. Work-life imbalance is particularly influential on burnout symptoms, while effort-reward imbalance most significantly predicts thoughts of leaving (3).
• A recent survey of Australian podiatrists found that 35% of respondents experienced burnout, which was linked to an intention to leave the profession (7).
• A 2004 survey revealed that 25% and 30% of newly qualified podiatrists in the United Kingdom and Australia, respectively, experienced burnout (5).
• Burnout has a prevalence of 36%–51% in medical and surgical residents (4).

 

How did they classify burnout in the study?

Burnout was measured using the abbreviated Maslach Burnout Inventory (aMBI), derived from the original 22-item Maslach Burnout Inventory human services scale (MBI-HSS), designed to measure burnout among health practitioners (8, 9).

 

The aMBI consists of nine questions across three subscales: emotional exhaustion (three questions), depersonalisation (three questions), and personal accomplishment (three questions). Responses are scored on a seven-point scale from 0 (‘never’) to 6 (‘daily’).

 

Additional questions measuring job satisfaction were included. They have been widely used in healthcare burnout research.

 

Higher scores on emotional exhaustion and depersonalisation indicate greater burnout, while lower scores on personal accomplishment and job satisfaction subscales also indicate burnout.

 

Participants were classified as experiencing burnout if they scored ‘moderate to high’ in two or more subscales, following criteria from previous studies.

 

It’s essential to acknowledge that there are various methods for identifying burnout (10).

 

Below (Table 2), you’ll find an example of an abbreviated Maslach Burnout Inventory used with nephrologists in Poland (11).

 

How were the associative factors for burnout identified?

The analysis, classification, questionnaires, and associations should not be viewed as simple, but explaining these in detail is beyond the scope of this article.

 

In Table 2 above, you’ll also find the individual characteristics of the participants. Think of it like this: based on the aMBI and other additional questions, individuals are grouped into two categories—’no burnout’ and ‘burnt out.’ These groups are then plotted with the characteristics of the people surveyed, and statistical analysis is performed.

 

Below, in Table 1, you will find a more detailed visual representation of the individuals’ characteristics.

 

What were the key findings?

The study found that one-third of podiatrists are experiencing burnout, with various individual and workplace factors linked to it. That is a significant number. Imagine meeting three podiatrists at random, perhaps at a conference or online—one of them would fall into the burnout category.

 

We should be grateful to the authors for compiling this data. Without their work, we wouldn’t have access to this valuable information. It is a significant undertaking.

 

What factors had a higher association with burnout? 

Statistically significant factors (p < 0.05) associated with burnout included:

• Being slightly younger and reporting poorer health.
• Experiencing higher levels of mental distress.
• Lower scores in resilience, extraversion, conscientiousness, and emotional stability.
• Less openness to new experiences.
• Lower levels of career risk-taking behaviour.
• Working more hours, with shorter consultation times, and seeing a greater number of patients.
• Engaging in more direct patient care hours.
• A greater tendency to bulk bill chronic disease management plans.
• Reduced access to professional development opportunities.

 

Additionally, with a significance level of p < 0.20, these factors were also linked to burnout:

• More recent entry into practice.
• Lower agreeableness scores.
• A greater likelihood of engaging in financial and clinical risk-taking behaviour.
• Working in private practice or across multiple locations.
• Intentions to leave the profession within five years.
• A higher proportion of patients with complex health or social issues.
• Lastly, common themes like higher workloads, longer hours, and seeing more patients mirrored trends seen in other healthcare professions.

 

Were there further findings in the research?

Plenty of findings. They include (but are not limited to) the following.

• Individual characteristics accounted for approximately 16.1% of the variance in burnout, with factors such as age, mental distress, resilience, and risk-taking behaviour playing a significant role.
• Workplace factors, including work setting, number of locations, and weekly work hours, contributed to 6.8% of the variance in burnout.
• Job satisfaction measures accounted for 29.1% of the variance in burnout, highlighting how job contentment strongly influences burnout levels.
• Participants experiencing burnout were more likely to lack a supportive peer network, have difficulty taking time off (or doing so at short notice), face unrealistic patient expectations, and lack support or supervision from a podiatrist with advanced skills.
• They were also more likely to have unpredictable work hours, experience higher stress from running their own practice, and perform tasks that could be handled by someone less qualified. Additionally, they were less able to work their preferred hours due to work availability and were more likely to want to change their working hours.
• These participants reported lower satisfaction with various aspects of their job, including their freedom to choose their work methods, variety of tasks, physical working conditions, opportunities to use their abilities, recognition for their work, hours of work, remuneration, level of responsibility, and the balance between personal and professional commitments.