Radiology is among medical specialties at higher risk of physician turnover, according to research published on December 15 in JAMA Network Open.
A team led by Dr. Jennifer Ligibel from the Dana-Farber Cancer Institute in Boston found that academic radiologists have a higher-than-average rate of intention to leave their institutions. However, professionals in nuclear medicine and neuroradiology had the lowest rates.
“Burnout, lack of professional fulfillment, and other well-being factors were associated with intention to leave, suggesting the need for a comprehensive approach to reduce physician turnover,” the Ligibel team wrote.
Recent data suggest a significant increase in physician turnover, contributing to staff shortages. Burnout is one known factor contributing to physicians leaving their jobs to pursue other medical careers or leave the field altogether. However, the researchers pointed out that less is known about other contributing factors and differences in intention to leave among medical specialties.
Ligibel and co-authors identified the prevalence of burnout, professional fulfillment, and the intention to leave by specialty across 15 academic sites in a survey conducted between 2019 and 2021. They also explored differences in one's intention to leave between medical specialties and identified associated individual and institutional factors.
The team included data from 18,719 academic physician survey respondents. Of these, 6,903 (37.9%) met the criteria for burnout and 7,301 (39.3%) met the criteria for professional fulfillment. Additionally, 5,177 (32.6%) reported moderate or greater intention to leave.
While burnout, professional fulfillment, and the intention to leave varied across specialties, the researchers found that radiology had the sixth-highest rate of intention to leave at 39.8%. The other highest specialties included anesthesiology, gastroenterology, thoracic surgery, neurological surgery, and critical care.
However, nuclear medicine had the lowest intention-to-leave rate at 13.6%, and neuroradiology had the third-lowest rate at 22.6%.
The team also employed a 0 to 10 scale that measured reciprocal causation between cultural factors, work efficiency factors, and individual physician factors . It reported that after adjusting for demographics, each one-point increase in burnout was directly tied to intention to leave, with an odds ratio (OR) of 1.52. Also, each on-point increase in professional fulfillment was inversely associated with intention to leave, with an OR of 0.64.
Finally, the researchers found other inverse associations with intention to leave with each one-point increase.
| Associations between one-point increases in burnout, professional fulfillment with intention to leave |
|
|---|---|
| Factors |
Odds ratio |
| Supportive leadership behaviors |
0.83 |
| Peer support |
0.93 |
| Personal-organizational values alignment |
0.81 |
| Perceived gratitude |
0.95 |
| COVID-19 organizational support |
0.88 |
| Electronic health record helpfulness |
0.95 |
| Depression |
1.08 |
| Negative impact of work on personal relationships |
1.09 |
The study authors wrote that these findings are relevant to predictions of staffing shortages in emergency medicine and other front-line medical specialties. This also includes the growing proportion of unfilled residency slots in some areas.
The authors also suggested that the survey’s timing with the COVID-19 pandemic may contribute to the high levels of burnout and intention to leave seen in the medical specialties.
“These results underscore the importance of the connections between academic physicians and both institutional leadership and mission, as well as point to the need for developing initiatives with a comprehensive approach that considers burnout, professional fulfillment, and other organizational and individual level well-being factors to help prevent physician turnover,” they added.
The study can be found in its entirety here.
