LAUSR

Physician burnout can have negative consequences for patients and physicians. Understanding trends in burnout over time can illuminate strategies to reduce it. Existing studies of changes in burnout over time have used different groups of physicians at each time point, introducing selection bias. In this longitudinal cohort and cross-sectional study that included a cohort of physicians who took the survey at both time points, we assessed differences in changes in burnout between 2013–2014 and 2019–2020 by physician characteristics, including race and sex, as well as clinical full-time employment. Abstract Objective Assessing changes in physician burnout over time can offer insight into the causes of burnout. Existing studies are limited by using different samples of physicians at each time point. Our objective was to assess changes in burnout between 2013–2014 and 2019–2020 overall and within a cohort of physicians who took the survey twice. Methods This is a longitudinal cohort and cross-sectional study of physicians in a major health system. They were administered the Maslach Burnout Inventory in 2013–2014 and 2019–2020. We separately assessed differences in odds of burnout and its subscales in 2013–2014 and 2019–2020 by physician characteristics and clinical time. We then assessed differences in the odds of reporting burnout and its subscales in 2019–2020 compared with 2013–2014 overall and by physician sex, race, and change in clinical full-time employment. Results There were 1220 respondents in 2013–2014, 503 in 2019–2020, and 149 who responded at both time points. Burnout increased from 35% to 56%. Compared with 2013–2014, physicians had 2.39 higher odds (95% confidence interval [CI] 1.92–2.98) of burnout in 2019–2020, and this change in burnout was significantly more pronounced for female versus male physicians (odds ratio 1.80; 95% CI 1.57–1.80). Compared with White physicians, non-White physicians had significantly lower odds of burnout at both time points, but their odds increased significantly more over time (odds ratio 1.36; 95% CI 1.05–1.57). Conclusions We found a substantial increase in burnout over time, which was particularly pronounced for non-White and female physicians. Assessment over time is essential for understanding problematic trajectories of burnout that may be obscured by cross-sectional studies.