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Cited by 340Healthcare professionals’ stress and burnoutSuicide and Self-Harm StudiesOccupational Health and Burnout

Association of Physician Burnout With Suicidal Ideation and Medical Errors

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Menon, Nikitha K., Shanafelt, Tait D., Sinsky, Christine A., Linzer, Mark, Carlasare, Lindsey, Brady, Keri J. S., Stillman, Martin J., Trockel, Mickey T.·2020·JAMA Network Open
DOI 10.1001/jamanetworkopen.2020.28780PMC PMC7726631
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Abstract

Importance: Addressing physician suicide requires understanding its association with possible risk factors such as burnout and depression. Objective: To assess the association between burnout and suicidal ideation after adjusting for depression and the association of burnout and depression with self-reported medical errors. Design, Setting, and Participants: This cross-sectional study was conducted from November 12, 2018, to February 15, 2019. Attending and postgraduate trainee physicians randomly sampled from the American Medical Association Physician Masterfile were emailed invitations to complete an online survey in waves until a convenience sample of more than 1200 practicing physicians agreed to participate. Main Outcomes and Measures: The primary outcome was the association of burnout with suicidal ideation after adjustment for depression. The secondary outcome was the association of burnout and depression with self-reported medical errors. Burnout, depression, suicidal ideation, and medical errors were measured using subscales of the Stanford Professional Fulfillment Index, Maslach Burnout Inventory-Human Services Survey for Medical Personnel, and Mini-Z burnout survey and the Patient-Reported Outcomes Measurement Information System depression Short Form. Associations were evaluated using multivariable regression models. Results: Of the 1354 respondents, 893 (66.0%) were White, 1268 (93.6%) were non-Hispanic, 762 (56.3%) were men, 912 (67.4%) were non-primary care physicians, 934 (69.0%) were attending physicians, and 824 (60.9%) were younger than 45 years. Each SD-unit increase in burnout was associated with 85% increased odds of suicidal ideation (odds ratio [OR], 1.85; 95% CI, 1.47-2.31). After adjusting for depression, there was no longer an association (OR, 0.85; 95% CI, 0.63-1.17). In the adjusted model, each SD-unit increase in depression was associated with 202% increased odds of suicidal ideation (OR, 3.02; 95% CI, 2.30-3.95). In the adjusted model for self-reported medical errors, each SD-unit increase in burnout was associated with an increase in self-reported medical errors (OR, 1.48; 95% CI, 1.28-1.71), whereas depression was not associated with self-reported medical errors (OR, 1.01; 95% CI, 0.88-1.16). Conclusions and Relevance: The results of this cross-sectional study suggest that depression but not physician burnout is directly associated with suicidal ideation. Burnout was associated with self-reported medical errors. Future investigation might examine whether burnout represents an upstream intervention target to prevent suicidal ideation by preventing depression.

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  • Physician burnout is strongly associated with higher rates of physician suicide, increased medical errors and worse patient care outcomes.

    “physician burnout is strongly associated with higher rates of physician suicide, increased medical errors and worse patient care outcomes.4 5”

    From Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: a systematic review and meta-analysis (2024) · cites this paper as [5]

    The Results report greater odds of self-reported medical errors with burnout, and the Discussion notes an association with patient complaints. But the Conclusions say depression, not burnout, was directly associated with suicidal ideation after adjustment; the study did not measure suicide rates. The claim also states broader patient-care outcomes than the reported errors and complaints establish. (LLM, conf=0.88)

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References 72 · Cited by 340

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Authors
Menon, N. K., Shanafelt, T. D., Sinsky, C. A., Linzer, M., Carlasare, L., Brady, K. J. S., Stillman, M. J., & Trockel, M. T.
Affiliations
  • Stanford Medicine (US)
  • American Medical Association (US)
  • Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
  • Boston University (US)
Corresponding author
Trockel, Mickey T.
ORCID
Venue
JAMA Network Open
Publisher
American Medical Association (AMA)
Published
2020-12-09
Volume
3
Issue
12
Pages
e2028780
ISSN
2574-3805 (ISSN-L)
DOI
10.1001/jamanetworkopen.2020.28780
PMC
PMC7726631
OpenAlex
W3111044931
Cited by
340
References
72
Citations by year
2026: 39 · 2025: 61 · 2024: 72 · 2023: 63 · 2022: 81 · 2021: 22 · 2020: 2
FWCI
43.86
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA Network Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
Keywords
physician burnout, suicidal ideation, depression, medical errors, physician suicide, occupational stress, attending physicians, postgraduate trainees, physician well-being, patient safety, professional fulfillment, Maslach Burnout Inventory
MeSH terms
Suicide Prevention, Adult, Burnout, Professional, Cross-Sectional Studies, Depression, Female, Humans, Male, Middle Aged, Physician Impairment, Physicians, Suicide, United States, Medical Errors, Self Report, Suicidal Ideation

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