Mistreatment and Discrimination Take Burnout Toll on Physicians

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By Christopher Cheney

Physicians who experience mistreatment and discriminatory behaviors by patients, families, and visitors have higher odds of burnout, a new research article says.

Physician burnout was a concern before the coronavirus pandemic, which has exacerbated the problem. Earlier research has linked physician burnout to negative personal and professional consequences.

The new research article, which was published by JAMA Network Open, is based on data collected from more than 6,500 physicians. The study has several key findings:

  • In the previous year, 29.4% of physicians had experienced racially or ethnically offensive comments by patients, families, or visitors. This mistreatment was more prevalent among female physicians (34.7%) than male physicians (26.0%).
  • In the previous year, 21.6% of physicians had a patient or family refuse to allow them to provide care because of the physician’s personal attributes.
  • In the previous year, female physicians (odds ratio 2.33) and Black physicians (odds ratio 1.59) were more likely to report mistreatment or discrimination.
  • Offensive racial or ethnic comments by patients, families, or visitors in the previous year were experienced 55.8% of Black physicians and 55.4% of non-Hispanic Asian, Native Hawaiian, of Pacific Islander physicians. These experiences were reported by 22.0% of White physicians.
  • In the previous year, 28.7% of physicians reported offensive sexist remarks by patients, families, or visitors, with this mistreatment reported by more female physicians (51.0%) than male physicians (15.1%).
  • In the previous year 20.5% of physicians reported unwanted sexual advances by patients, families, or visitors, with this mistreatment reported by more female physicians (29.6%) than male physicians (15.0%).
  • At least once in the previous year, 14.8% of physicians reported physical harm by patients, families, or visitors. Physical harm was reported by 31.8% of non-Hispanic male physicians of two or more races, a rate more than twice that of other groups.
  • The researchers scored mistreatment on a scale from 0 (no mistreatment) to 3 or greater. Higher scores were associated with higher odds of burnout: score of 1 odds ratio 1.27, score of 2 odds ratio 1.70, score of 3 or greater odds ratio 2.20.

“In this study, mistreatment and discrimination by patients, families, and visitors were common, especially for female and racial and ethnic minority physicians, and associated with burnout. Efforts to mitigate physician burnout should include attention to patient and visitor conduct,” the research article’s co-authors wrote.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.