Large study finds burnout is prevalent in the optometry profession
A study published in the Journal of Optometry found that over half of optometrists are showing signs of burnout. Kaleb Abbott, OD, an optometrist and assistant professor at the University of Colorado School of Medicine, and Editorial Advisory Board Member of Optometry 360, dove into the details of the data to present key demographics and factors that were protective from burnout and those that were most associated with burnout.
Kaleb Abbott, OD:
My name is Kaleb Abbott. I’m an optometrist and assistant professor at the University of Colorado School of Medicine. I practice in our dry eye clinic; 75% of the time, I’m seeing patients. About 25% of the time, I’m doing research, and that’s what prompted me to do this study on burnout of optometrists in the United States. This is the largest ever study conducted of burnout amongst U.S. optometrists with 1,436 responses.
Question:
Your study on optometrists and burnout was just published. Can you share some background on this study?
Kaleb Abbott, OD:
Yes. The aim of this study was to determine the prevalence of burnout amongst clinical optometrists practicing in the United States, and then to identify risk factors that are contributing to burnout. We used a Mini Z burnout questionnaire. This is a very popular questionnaire in healthcare that’s specifically tailored to burnout. It consists of 10 items rated on a 5-point Likert scale where we evaluate burnout outcomes and then contributing factors. Then we also asked a lot of questions regarding demographics, and clinical practice, and lifestyle, and things like that. The survey was distributed through the American Academy of Optometry via their email listservs, and then the data was collected anonymously through a program called REDCap. We also distributed the survey through some other means, ODs on Facebook, Corporate Optometry, ODs on Finance, OD Finance Professionals, through your website, Optometry 360, and then the archive of Wellness & Nutrition Society also.
Question:
What were some key takeaways from this study?
Kaleb Abbott, OD:
I think the main highlight from the study is that it revealed concerning rates of burnout amongst U.S. optometrists; 53.6% of U.S. optometrists reported symptoms of burnout, so that means that the majority of us that are practicing, that are seeing patients in the U.S., have symptoms of burnout. Of those that are reporting symptoms of burnout, 61% were classified as mild, 30% were classified as moderate, and about 8% were classified as severe. Also, notably, we found that female optometrists reported significantly higher rates of burnout as compared to male optometrists. It affected 61% of females, but only about 41% of males.
Question:
What demographic and practice characteristics were associated with burnout?
Kaleb Abbott, OD:
Well, as briefly mentioned already, females were disproportionately affected as compared to males. Not only did females report a higher rate of burnout, but they also were more likely to have severe symptoms of burnout. Females also had 1.78 higher odds ratio of mild burnout and 2.16 higher odds ratio of having moderate to severe burnout, so really disproportionately affected females as compared to males.
We also looked at practice setting. We wanted to know in what practice settings are optometrists experiencing the most burnout versus the least amount of burnout. The lowest burnout was reported amongst those that were at private practices, regardless of size. It could be solo practices, small or large, although large private practices had the lowest amount of burnout overall. Then academic optometrists, practicing at optometry schools, had less burnout. Then the places that had the most burnout, by far, number 1 was teleoptometry. However, only 3 out of the 1,436 responses were those practicing in teleoptometry. We didn’t really have a good enough sample size to make much of that. But of those 3 people, they were quite burnt out.
The next was hospital-based and then integrative healthcare systems. Places like the VA or Kaiser, it’s like that had higher amounts of burnout. Then were departments of ophthalmology, so optometrists practicing in departments of ophthalmology reported higher symptoms of burnout as well.
Question:
Were there any other key features that were associated with burnout?
Kaleb Abbott, OD:
Yeah. Interestingly, those without children had higher symptoms of burnout. Those with children had less burnout. Regarding commute time, if you had a short commute, less than 15 minutes, you had less burnout. If you had a long commute though, greater than 60 minutes, you had less burnout. It was those with more moderate commute, 15 minutes to 60 minutes, that had the most burnout. If you had a spouse who is practicing in healthcare, those optometrists reported fewer symptoms of burnout. Then when it comes to career length, those at the beginning of their career and at the very end of their career, practicing less than 5 years or more than 30 years, had less burnout. Those in their mid-career, practicing between 5 and 30 years, had the most amount of burnout.
There was no association with burnout regarding the region of the U.S. It was fairly similar throughout all different geographic regions. No association with race or ethnicity. When it comes to residency training, in general, people who completed a optometric residency had more burnout symptoms, with the exception of those who trained in low vision and vision rehabilitation. Those individuals had fewer symptoms of burnout. Then some other trends that we noted was that, the more patients you saw in a half-day, the more burnout you had; the higher number of clinic days per week, the more burnout you also had. Those of us who use electronic health records, electronic records for our patient charting, had more burnout than those who used paper charts.
Question:
What associations, if any, did the study highlight for those who experienced burnout?
Kaleb Abbott, OD:
Yeah. In general, self-reported burnout was associated with some other negative findings, too. Those who were burnt out had less job satisfaction, higher levels of stress. They felt that they had to do patient charting at home more frequently. They felt that, when they were at work, they didn’t have enough time for patient charting and documentation. They reported a lack of control over their workload and schedules, a hectic work environment, reduced team efficiency, and they reported that their professional values didn’t align with leadership within their practice or department.
Question:
What were the best protectants against burnout? What were the top risk factors for burnout?
Kaleb Abbott, OD:
Yeah. The protective factors included being male, having children, having either a short commute or a very long commute, having a spouse that worked in healthcare, being early in your career, less than 5 years, or late in your career, greater than 30 years, and working in places like private practice and optometry schools. Risk factors included those who were female, those who spent more time in clinic, had a higher patient volume that used EHRs for their charting, those that were in the mid-career, 5 years to 30 years, people without children had higher levels of burnout, and then people who worked in commercial settings, hospital-based settings, integrative care systems, and optometrists practicing in departments of ophthalmology.
Question:
What are your hopes and expectations with the release of this study? Do you believe these findings could offer a launching pad for better work-life balance?
Kaleb Abbott, OD:
Yeah, I think this was a really important initial study. This was, again, the largest study that was ever done of burnout amongst U.S. optometrists. We found that, as of right now, burnout is a significant concern in our profession. We also found out that females are disproportionately affected as compared to males. I think we need more research to figure out why optometrists are burnt out, what we can do to address burnout, and then we also need to have a better understanding of why females are more affected than males.
