P2.157: Addressing the Impact of Gender and Parenting on Burnout in the Pediatric Emergency Physician

Background: Burnout is a widespread crisis in physicians, prompting the surgeon general to issue an advisory on Health Worker Burnout in 2022. Burnout is consistently higher among Emergency Medicine (EM) physicians, with pediatric EM (PEM) physicians facing unique distress. Burnout is reportedly higher in early career physicians and women practicing PEM. Currently women represent almost 70% of PEM trainees and almost 60% of attendings. While studies have assessed burnout in PEM physicians, the impact of sex and parenting on burnout has not been studied.

Methods: Utilizing the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS), the objective of this study is to understand the rates of burnout in PEM physicians. Burnout was assessed by emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA) by reported sex, race, and parenting. PEM attendings and fellows were notified of the survey through the Brown University PEM Listserv and two targeted Facebook groups. The survey included the MBI-HSS, demographics, and questions regarding partnered relationships and child caregiving. Demographics were reported with descriptive statistics, and sex differences were assessed using Pearson Chi-Square and Fisher’s Exact test for categorical variables, and Two-sample t-test for continuous variables. Multi-group structural equation modeling was utilized to interpret the relationships among burnout, sex, and parenting.

Results: Of 604 surveys initiated, 453 met inclusion criteria, completed the MBI-HSS, and were included for analysis. Respondents were 70% female, 68% parents, 65% white, 83% attendings, and 77% worked at an academic hospital. Women were more likely to report high EE and DP, and low PA. Of all respondents, 47% had high EE, 51% high DP, and 44% low PA. Women with children 6-18 years, >18 years, or without children had higher EE than men of similar parenting status (p < 0.05, 0.08, 0.01, respectively). Men with children < 6 years had higher DP than women with children of the same age but was otherwise the same for both sexes (p < 0.03). Women with school aged children had almost twice the rate of burnout compared to men with children of similar ages (p < 0.04).

Conclusion: Physician burnout is impacted by EE, DP, and PA, and other complex factors. Female PEM physicians have higher rates of EE at baseline, further exacerbated by being a mother. With burnout frequently leading to attrition, the ongoing critical shortage of pediatric subspecialists, and with women primarily comprising the current PEM workforce, this is especially concerning.