Hispanic, Female Healthcare Providers More Likely to Report Clinician Burnout

Female and Hispanic healthcare providers are more vulnerable to clinician burnout than other physicians, according to a JAMA Network Open study.

The cross-sectional study extracted approximately 1.5 million inbasket messages for 609 physicians from multiple specialties. Previous research has found that higher EHR inbasket message volumes are associated with physician burnout. The study also found that physicians reporting burnout had, on average, higher message volumes. However, these differences did not reach significance.

The study authors used natural language processing (NLP) to understand inbasket message sentiment better. While they did not find significant associations between burnout and message sentiment, descriptive analyses of negative messages still yielded several interesting results.

Analyses of high-frequency words included many expletives, demonstrating the hatred of some messages arriving at physicians’ inbaskets. Some messages expressed negativity toward physicians, while others expressed frustrations at navigating complex healthcare systems.

“These messages could still be stressful for physicians, particularly if the patients’ frustration is related to factors beyond the individual physician’s control,” the authors wrote. “However, these messages highlight the need for health systems to examine root causes of patient frustrations and improve patient engagement in their care.”

The researchers also found several high-frequency words signifying violence or hatred. Health systems should work to ensure that the inbasket does not become a place for physician abuse and cyberbullying.

“Posting reminders in EHR patient portals to use kind language when sending messages, applying filters for expletives or threatening words, and creating frameworks for identifying patients who frequently send negative messages are potential strategies for mitigating this risk,” the authors wrote.

Multivariable models identified subgroups of providers who may be particularly vulnerable to clinician burnout, even when accounting for variations in message volume and sentiment.

These groups include physicians with 15 or fewer years of medical practice, female physicians, and Hispanic/Latino physicians.

“Our finding of Hispanic/Latino physicians being associated with higher odds of burnout contrasts with a prior study that reported lower likelihood of burnout among minoritized racial and ethnic groups,” the authors wrote. “However, that study analyzed data from 2017 to 2018, whereas we surveyed physicians after the onset of the COVID-19 pandemic in 2020.”

A more recent study found that discriminatory behaviors by patients, families, and visitors were more common toward female physicians and those from racial and ethnic minorities. These instances of discrimination were associated with higher burnout rates.