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Burnout symptoms associated with racial bias in medical residents

Pushing back against burnout symptoms can reduce bias and disparities in care, research shows.

Jeff Lagasse, Associate Editor

Mayo Clinic researchers have found an association between increased symptoms of burnout and heightened racial bias in medical residents, with the results of their study appearing in JAMA Network Open.

The central thesis is that physicians not operating at their peak mental and emotional capabilities may find it more difficult to fight their own biases. This leads to the conclusion that pushing back against burnout symptoms can reduce bias and disparities in care.

WHAT'S THE IMPACT

The results suggests this may indeed be the case. More than 3,000 physicians from across the country who are not black were surveyed for symptoms of burnout. They were then given tests of explicit racial bias, a direct rating of how warmly they feel toward a person, and implicit racial bias, which is based on descriptive word association. Researchers conducted these surveys in the second and third years of residency to assess changes over time.

Physicians experiencing high symptoms of burnout in the second year tended to respond with more racial bias, explicit and implicit. At follow-up in the third year, racial bias decreased across the board.

The greatest reduction in bias, however, occurred in those physicians who experienced burnout in the second year but had recovered from burnout by the third year. This suggests that treating burnout could make a tangible improvement in racial bias in the clinic.

THE LARGER TREND

Health disparities between ethnic groups in the U.S. are well-documented. The Centers for Disease Control and Prevention reports a higher incidence of many health conditions among black Americans, including stroke, heart disease, infant mortality, obesity and diabetes.

Many studies have investigated the ways in which differences in physician care contribute to this effect, but little previous research has explored how a physician's mental state can trigger these disparities.

Rates of burnout -- a condition marked by emotional exhaustion, cynicism and negative feelings toward one's job -- are nearly doubled in physicians, compared to the general population

While the differences in scores between the groups in the Mayo Clinic study are small, the authors suggest that further studies could better explore whether the relationship between burnout and racial bias truly is one of cause and effect, and if so, foster solutions.

Twitter: @JELagasse

Email the writer: jeff.lagasse@himssmedia.com