Burnout among Dutch general practitioners: An empirical study of the determinants of physician burnout

Abstract

This study aims to examine to what extent Dutch GPs are at risk for burnout, and to identify personal, professional and practice related characteristics that are associated with high burn out scores. In the extant literature, physicians are identified as professionals who are high risk for burnout. In the past decade, working conditions for general practitioners (GPs) in the Netherlands have changed for the worse. There are no recent data on GP burnout in the Netherlands. Although much is known in the literature about factors that are associated with burnout and the role job demands and resources play in getting burned out, the extent to which these findings apply in the context of Dutch GPs is unknown. This study is designed as a quantitative, survey based, empirical study. An invitation to complete an online survey was sent to 4,000 GPs in the Netherlands, of whom close to 1,300 participated in this study (33% response rate). The data were analysed using IBM SPSS 22.0. The data analysis consisted of a descriptive analysis of the data with an emphasis on the outcome of burnout measurements, as well as an inferential analysis of the data with an emphasis on the association between respondents’ characteristics and burnout measurements. The results from this study indicate, that one in seven practicing Dutch GPs could be classified as burned out with fulltime working GPs reporting an average working week of 62 hours. According to the findings, the amount of hours worked per week is the most important determinant of emotional exhaustion. Variation in emotional exhaustion, depersonalisation and professional efficacy can to a large extent be explained by variation in demands (administrative burden, work-home conflict, psychological job demands) and resources (decision latitude, co-worker support and home support). Increased job demands are predominantly associated with emotional exhaustion, while a scarcity of resources predominantly leads to increased depersonalisation and reduced professional efficacy. The findings demonstrate, that a bigger job size, more hours worked and a more responsible position held, are associated with higher experienced demands, which is in turn associated with unfavourable burnout scores, particularly increased emotional exhaustion. Working in a group setting, being professionally active outside of one’s own practice and being in a relationship were found to be associated with increased resources, which is in turn associated with favourable burnout scores, particularly decreased depersonalisation and increased professional efficacy. Based on the findings of this study, three recommendations for government bodies, healthcare providers and other healthcare stakeholders were formulated: 1) Reduce the length of the working week, predominantly by reducing the number of allocated patients per GP. This recommendation implies an increase in the GP workforce; 2) Undertake a comprehensive analysis of the quantity, type and purpose of administrative duties currently performed by GPs and trim unnecessary paperwork and bureaucracy within the GP practice and 3) Increase co-worker support, either within the GP practice or by using the existing collegiate support infrastructure.