Infectious Disease

Burnout in PAs contributes to medical errors and mental health problems

September 01, 2021

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Smith does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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Burnout, exhaustion, and withdrawal are common among medical assistants and can lead to anxiety, depression, and medical errors, according to evidence published in the Journal of the American Academy of Physician Assistants.

Still, 53% of PAs reported moderate to high professional fulfillment, Christmas E. Blacksmith, MA, Senior Director of PA and Industry Research and Analysis at the American Academy of Physician Assistants, and colleagues wrote.

Blackstone SR et al. JAPA. 2021; doi: 10.1097 / 01.JAA.0000769676.27946.56.

“Symptoms of burnout, along with depression, are critical contributors to professional development and medical failure,” Smith told Healio Primary Care. “This supports the growing evidence that health systems need to address burnout in order to provide patient care among all clinicians to optimize and support your staff. “

Smith and colleagues surveyed 880 PAs using an online questionnaire to rate a variety of metrics, including the Professional Fulfillment Index, Patient Health Questionnaire-2, and Generalized Anxiety Disorder Scale, as well as depression metrics and self-reported medical errors. The average age in the study cohort was 38.9 years; the average duration of clinical practice was 10.6 years; and 70.6% of the participants were women. In addition, 24.9% of the participants worked in a surgical specialty, 21.1% in primary care and 13.6% in internal medicine. Smith and colleagues used two serial models of mediation to determine the relationship between depression, burnout, and professional outcomes.

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The exhaustion and burnout scores ranged from 0 to 16, with a mean of 5.6. Interpersonal distancing scores also ranged from 0 to 24, with a mean of 5.6. According to the researchers, higher values ​​correlated with greater burnout and disengagement. They found that 34.3% of participants experienced general burnout, 45.9% job exhaustion and 30.2% interpersonal distancing.

The professional fulfillment points range from 0 to 24, with a mean of 14.51. Medical errors ranged from 0 to 20, with a mean of 3.53; 80% of the participants reported at least one mistake. The scores for depression and anxiety also ranged from 0 to 6 and 0 to 12, with average scores of 0.79 and 4.5, respectively. Overall, 6% of participants exceeded the threshold for depression and 12.6% for moderate to severe anxiety.

The researchers found that depression affects feelings of professional fulfillment and medical failure, but these are also mediated by symptoms of burnout, particularly work exhaustion and interpersonal withdrawal.

“When you experience work exhaustion or interpersonal distancing, you are more likely to make mistakes. For clinicians, the effects are greater than for other professionals, ”said Smith. “One of the most important things to remember is that PAs report these errors themselves and may adhere to high quality of care. If they do not reach this level, they consider it a “mistake” in the way care may have been delivered differently. “

These and other studies show that “burnout is a growing problem for PAs,” the researchers wrote. Burnout also affects other health professionals, including doctors and medical students. Overall, clinician burnout contributes to “lower productivity of clinicians and increased turnover, which leads to reduced patient access and increased system costs,” the researchers write.

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