Physician Burnout in Primary Care during the COVID-19 Pandemic: A Cross-Sectional Study in Portugal

Sofia Baptista, Maria Cunha, Carla Serrão, Andreia Rodrigues Silva, Andreia Teixeira, Luísa Castro, Ivone Duarte

Background:

Primary care physicians have been present on the frontline during the ongoing pandemic, adding new tasks to already high workloads.

Research questions:

Our aim was to evaluate burnout in primary care physicians during the COVID-19 pandemic, as well as associated contributing factors.

Method:

Cross-sectional study with an online questionnaire disseminated through social media, applying the snowball technique. The target population was primary care physicians working in Portugal during the first outbreak of the COVID-19 pandemic. In addition to sociodemographic data, the questionnaire collected responses to the Copenhagen Burnout Inventory (CBI), the Resilience Scale and the Depression, Anxiety, and Stress Scales (DASS-21). Data were collected from May 9 to June 8, 2020, a period comprising the declaration of a national calamity and then state of emergency, and the subsequent ease of lockdown measures. Levels of burnout in 3 different dimensions (personal, work, and patient-related), resilience, stress, depression, and anxiety were assessed. Logistic regression analyses were conducted to identify factors associated with burnout levels.

Results:

Among the 214 physician respondents, burnout levels were high in the 3 dimensions. A strong association was found between gender, years of professional experience, depression and anxiety, and burnout levels.

Conclusions:

Physician burnout in primary care is high and has increased during the pandemic. More studies are needed in the long term to provide a comprehensive assessment of COVID-19'simpact on burnout levels and how to best approach and mitigate it during such unprecedented times.

Points for discussion:

Burnout has negative impacts on physicians, patients, and healthcare organizations. Our findings reinforce that strategies to counteract physician burnout during a pandemic need to be further investigated.

Our workgroup suggests next steps should include, at an organizational level, involving physicians in designing guidelines and contingency plans and also in implementing physician’s access to feedback channels.

A supportive network should be created, including childcare, transportation, and lodging. Emotion management strategies and self-care should also be endorsed, encompassing rest, work breaks, sleep, shift work, fatigue, and healthy lifestyle behaviors

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