Physician burnout reached as high as 45% in some European hospitals and 34% in the US, according to a cross-sectional study published in JAMA Network Open.

Indicators of poor physician well-being were widespread across Europe and the US, with nearly one in three European physicians and almost one in four US physicians reporting intent to leave their hospital within one year. Investigators highlighted that modifiable hospital factors—including nurse staffing adequacy, supportive clinical care environments, and effective interdisciplinary teamwork—were associated with improved physician outcomes. In the US, a 10% increase in favorable clinical care environments was associated with reduced odds of intent to leave and high burnout. In Europe, a 10% improvement in nurse staffing adequacy was associated with reduced odds of high burnout and job dissatisfaction. Modeled estimates suggested that raising staffing adequacy to the 90th percentile could reduce intent to leave by as much as 11.2 percentage points in Ireland and 4.3 percentage points in the US.

These findings were derived from a study of 21,396 clinicians across 105 hospitals, including 1,149 physicians in Europe and 5,334 physicians in the US. Nurses served as independent informants of hospital conditions, with more than 14,000 respondents reporting on staffing adequacy, clinical care environments, and teamwork.

Data collection occurred in 2023 in participating European hospitals and in 2021 in US Magnet hospitals. Nurse-reported staffing adequacy varied widely, ranging from 6% to 59% across European hospitals and from 6% to 78% across US hospitals. Less than half of nurses in US hospitals (44%) reported adequate staffing, compared with 26% in Europe. Favorable interdisciplinary teamwork ranged from 8% to 82% across all hospitals, and clinical care environment scores ranged from 2.4 to 3.5.

Physicians in all settings reported high rates of burnout, job dissatisfaction, and intent to leave. Job dissatisfaction was reported by 29% of physicians in Europe and 16% in the US. Poor workload control was reported by 74% of physicians in Europe and 64% of physicians in the US, while poor work-life balance was reported by 61% in Europe and 38% in the US.

Researchers noted that the cross-sectional design limits causal interpretation and that the participating Magnet hospitals in the US and intervention-oriented hospitals in Europe may not reflect all hospitals in their respective countries. They also acknowledged that differences in data collection periods and substantial variation in physician well-being across hospitals could have influenced the results but may also indicate opportunities for organizational improvements.

“Having sufficient nurses to get the work done seems to be an essential foundation in the hierarchy of organizational priorities to foster clinician well-being,” noted lead author Linda H. Aiken, PhD, RN, of the Center for Health Outcomes and Policy Research; Leonard Davis Institute of Health Economics; School of Nursing, University of Pennsylvania, Philadelphia, and colleagues.

Reinhard Busse, DrMed, MPH, reported serving on a national hospital reform commission from 2022 to 2025, and Claudia B. Maier, DrPH, MSc, Dipl-Nursing, reported receiving Bosch Foundation grant support and separate fees from the World Health Organization EURO, with no additional disclosures noted.

Source: JAMA Network Open