Factors associated with well-being and burnout among US internal medicine physicians: a cross-sectional survey

BMJ Qual Saf. 2025 Sep 27:bmjqs-2025-018813. doi: 10.1136/bmjqs-2025-018813. Online ahead of print.

ABSTRACT

OBJECTIVE: Because physician burnout negatively affects patients, organisations and those impacted, we aimed to identify and evaluate factors contributing to burnout among internal medicine physicians in the USA.

DESIGN: Cross-sectional survey conducted between 23 June 2023 and 8 May 2024.

SETTING: A national multicentre study conducted in the USA.

PARTICIPANTS: Random sample of non-subspecialty internal medicine physicians identified through Physician Professional Data, a database maintained by the American Medical Association. Of 1421 eligible physicians, 629 (44.3%) responded.

MAIN OUTCOME MEASURES: The 42-item survey collected data on multiple factors-professional environment, community and personal-hypothesised to influence well-being. Burnout domains, including emotional exhaustion, depersonalisation and reduced personal accomplishment, were measured using the Maslach Burnout Inventory-Human Services Survey.

RESULTS: A total of 9.8% (61/622) participants had extreme burnout as defined by meeting thresholds for all three burnout domains. In multivariable regression analysis, several aspects of the professional environment (eg, workload, lack of autonomy) were statistically significantly associated with elevated odds of burnout. Community factors statistically significantly associated with reduced odds of burnout included a supervisor who empowers and treats the physician with respect and dignity and greater support from organisational leaders. Mindful awareness and a sense of purpose were statistically significantly inversely associated with odds of burnout.

CONCLUSION: Burnout among US internal medicine physicians is common and influenced by many factors. Interventions to elevate well-being should be multi-faceted and seek to reduce workload, augment autonomy, bolster support and perceptions of value from leaders and co-workers and foster environments conducive to mindful practice and sense of purpose.

PMID:41015526 | DOI:10.1136/bmjqs-2025-018813