Factors Associated with Physician Tolerance of Uncertainty: an Observational Study
Open accessAbstract
Background Physicians need to learn and work amidst a plethora of uncertainties, which may drive burnout. Understanding differences in tolerance of uncertainty is an important research area.Objective To examine factors associated with tolerance of uncertainty, including well-being metrics such as burnout.Design Online confidential survey.Setting The Massachusetts General Physicians Organization (MGPO).Participants All 2172 clinically active faculty in the MGPO.Main measures We examined associations for tolerance of uncertainty with demographic information, personal and professional characteristics, and physician well-being metrics.Key results Two thousand twenty (93%) physicians responded. Multivariable analyses identified significant associations of lower tolerance of uncertainty with female gender (OR, 1.23; 95% CI, 1.03-1.48); primary care practice (OR, 1.56; 95% CI, 1.22-2.00); years since training (OR, 0.99; 95% CI, 0.98-0.995); and lacking a trusted advisor (OR, 1.25; 95% CI, 1.03-1.53). Adjusting for demographic and professional characteristics, physicians with low tolerance of uncertainty had higher likelihood of being burned-out (OR, 3.06; 95% CI, 2.41-3.88), were less likely to be satisfied with career (OR, 0.37; 95% CI, 0.26-0.52), and less likely to be engaged at work (RR, 0.87; 95% CI, 0.84-0.90).Conclusion At a time when concern about physician well-being is high, with much speculation about causes of burnout, we found a strong relationship between tolerance of uncertainty and physician well-being, across specialties. Particular attention likely needs to be paid to those with less experience, those in specialties with high rates of undifferentiated illness and uncertainty, such as primary care, and ensuring all physicians have access to a trusted advisor. These results generate the potential hypothesis that efforts focused in understanding and embracing uncertainty could be potentially effective for reducing burnout. This concept should be tested in prospective trials.
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Women often exhibit higher levels of IU and score higher in constructs related to health anxiety and IU, showing a stronger relationship between IU and negative future orientation.
“Studies indicate that women often exhibit higher levels of IU [108] and score higher in constructs related to health anxiety and IU [109,110], showing a stronger relationship between IU and negative future orientation.”
From Impact of Media-Induced Uncertainty on Mental Health: Narrative-Based Perspective. (2025) · cites this paper as [109]
The Results (Tolerance of Uncertainty and Sociodemographic Characteristics; page not provided) associate female gender with lower tolerance of uncertainty, supporting the direction of the claim attached to this citation. The study measured physicians’ discomfort with uncertainty in patient care, so it does not establish that women generally have higher intolerance of uncertainty. The health-anxiety and negative-future-orientation portions are not specifically attributed to this source in the citing sentence. (LLM, conf=0.86)
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- Authors
- Begin, A. S., Hidrue, M., Lehrhoff, S., del Carmen, M. G., Armstrong, K., & Wasfy, J. H.
- Affiliations
- Massachusetts General Hospital (US)
- Harvard University (US)
- Venue
- Journal of General Internal Medicine
- Published
- 2021-04-26
- Volume
- 37
- Issue
- 6
- Pages
- 1415-1421
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC8074695
- OpenAlex
- W3158323272
- Cited by
- 73
- References
- 57
- Citations by year
- 2026: 10 · 2025: 21 · 2024: 15 · 2023: 14 · 2022: 10 · 2021: 3
- FWCI
- 11.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association (18 CDA 34110215)
- Center for Educational Innovation and Scholarship, MGH (N/A)
- Massachusetts General Physicians Organization (N/A)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- uncertainty tolerance, physician burnout, physician well-being, primary care physicians, trusted advisor, gender differences, career satisfaction, work engagement
- MeSH terms
- Burnout, Professional, Female, Humans, Job Satisfaction, Prospective Studies, Surveys and Questionnaires, Uncertainty, General Practitioners
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