Beyond Burnout: Workplace Social-Cultural Factors Linked to Intention to Leave Among Physicians.

Abstract

Data on the association of workplace social-cultural factors and physicians' intention to leave is lacking. To examine how demographic, occupational, and workplace social-cultural factors are associated with physicians' intention to leave and how workplace factors moderate the association between burnout and intention to leave. An institution-wide survey was distributed to faculty at an urban academic health system between 7/21/2022 and 9/14/2022. Intention to leave one's job was assessed with "What is the likelihood that you will leave your current position or role within the next 2 years?" and burnout with the Maslach Burnout Inventory-2. Multivariable logistic regression examined correlates of intention to leave one's job and the role of workplace social-contextual factors in moderating the association between burnout and this outcome. A total of 1534 faculty (41.6%) completed the survey, of whom 829 had clinical responsibilities and 112 (13.5%) reported a high intention to leave their job. High workplace organizational culture scores (relative variance explained (RVE) = 35%) and leadership support (RVE = 27%) were negatively associated with intention to leave, while burnout (RVE = 17%) was associated with a greater likelihood. Post hoc analyses indicated that having a caring work environment, an efficient clinical care team, and leaders that provided feedback or who kept faculty informed about changes were associated with a lower likelihood of intention to leave. Clinical care team efficiency moderated the association between burnout and intention to leave; physicians who screened positive for burnout were more than five times less likely to report a high intention to leave their job (9.9% vs. 53.0%). Positive workplace culture and strong leadership support are associated with a lower intention to leave among physicians, whereas burnout is associated with a higher likelihood of leaving. Greater perceived efficiency of one's clinical care team may mitigate the effect of burnout on a physician's intention to leave.