Table 1.
Self-Reported Professional Behaviors in the Last Year and Cost-Conscious Attitudes Among Physicians With and Without Burnout
| Overall | Burnout | OR (95% CI) | p value | ||
|---|---|---|---|---|---|
| With | Without | ||||
| Professional behaviors | |||||
| Documented something (e.g., review of systems) had forgotten to do so that could “close out” an encounter in the EHR. |
243/759 (31.9%) |
139/372 (37.4%) |
103/387 (26.6%) |
1.64 (1.21–2.23) |
0.002 |
| Documented a part of the physical exam that had not been examined to justify a billing code. |
148/795 (18.6%) |
89/387 (23.1%) |
59/410 (14.4%) |
1.80 (1.25–2.59) |
0.002 |
| Assigned an indication for a test different from why really ordered so that it would be reimbursed by the patients’ insurance and the patient would not have to pay out of pocket. |
249/784 (31.8%) |
150/377 (40.0%) |
99/409 (24.2%) |
2.11 (1.55–2.86) |
< 0.0001 |
| Did not discuss all treatment options with patients because was too busy. |
214/815 (26.3%) |
136/390 (34.9%) |
78/425 (18.4%) |
2.40 (1.74–3.31) |
< 0.0001 |
| Requested CME credit for a lecture, course, or activity not attended. |
40/815 (4.9%) |
28/387 (7.2%) |
12/428 (2.8%) |
2.51 (1.28–4.91) |
0.004 |
| Cost-conscious attitudes | |||||
| I try not to think about the cost to the health care system when making treatment decisions. | |||||
| Disagree/strongly disagree* | 513 (62.1%) | 241 (61.6%) | 272 (62.5%) | ref | |
| Strongly agree/agree† | 313 (37.9%) | 150 (38.4%) | 163 (37.5%) | 1.04 (0.78–1.37) | 0.79 |
| It is unfair to ask physicians to be cost-conscious and still keep the welfare of their patients foremost in their minds. | |||||
| Disagree/strongly disagree* | 446 (53.9%) | 194 (49.2%) | 252 (58.1%) | ref | |
| Strongly agree/agree† | 382 (46.1%) | 200 (50.8%) | 182 (41.9%) | 1.43 (1.09–1.88) | 0.01 |
| Doctors are too busy to worry about the costs of tests and procedures. | |||||
| Disagree/strongly disagree* | 563 (68.2%) | 232 (59.3%) | 331 (76.3%) | ref | |
| Strongly agree/agree† | 262 (31.8%) | 159 (40.7%) | 103 (23.7%) | 2.20 (1.63–2.97) | < 0.0001 |
| Cost to society is important in my decisions to use or not to use an intervention. | |||||
| Strongly agree/agree* | 512 (62.9%) | 246 (62.9%) | 266 (62.9%) | ref | |
| Disagree/strongly disagree† | 302 (37.1%) | 145 (37.1%) | 157 (37.1%) | 1.00 (0.75–1.33) | 0.99 |
| It is my responsibility to try to contain health care costs. | |||||
| Strongly agree/agree* | 618 (75.3%) | 277 (70.7%) | 341 (79.5%) | ref | |
| Disagree/strongly disagree† | 203 (24.7%) | 115 (29.3%) | 88 (20.5%) | 1.61 (1.17–2.22) | 0.004 |
| There is currently too much emphasis on costs of tests and procedures. | |||||
| Disagree/strongly disagree* | 468 (57.4%) | 219 (56.7%) | 249 (58.0%) | ref | |
| Strongly agree/agree† | 347 (42.6%) | 167 (43.3%) | 180 (42.0%) | 1.06 (0.80–1.39) | 0.71 |
Respondents were considered to have symptoms of burnout if they had high emotional exhaustion or high depersonalization scores (see the “Methods” section)
*Favorable
†Unfavorable