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PURPOSE OF REVIEW: Physician burnout is well-described in the literature. We analyze the effects of the COVID-19 pandemic on burnout in trauma and acute care surgeons (TACS). RECENT FINDINGS: Along with other healthcare workers and trainees, TACS faced unprecedented clinical, personal, and professional challenges in treating a novel pathogen and were uniquely affected due to their skillset as surgeons, intensivists, and leaders. The pandemic and its consequences have increased burnout and are suspected to have worsened PTSD and moral injury among TACS. The healthcare system is just beginning to grapple with these problems. SUMMARY: COVID-19 significantly added to the pre-existing burden of burnout among TACS. We offer prevention and mitigation strategies. Furthermore, to build upon the work done by individuals and organizations, we urge that national institutions address burnout from a regulatory standpoint.

BACKGROUND: Healthcare professionals experience stressors in the workplace, putting them at elevated risk for burnout. The cardiac catheterization lab is a dynamic environment with high-acuity patients; however, little has been published investigating burnout syndrome among healthcare workers. The aim of the study was to identify the prevalence, demographic, and workload factors, which contribute to burnout syndrome among this population. METHODS: This is a multicenter cross-sectional study assessing burnout with the Maslach Burnout Inventory (MBI) among registered nurses and registered cardiac invasive specialists working in the catheterization/electrophysiology lab and cardiac observation unit at four hospital centers in the metro Detroit area. RESULTS: Of the 48 participants, 69% (n = 33) were female. The overall prevalence of burnout syndrome was 33% (n = 16). Significantly more males experienced burnout than females (P < 0.05). Of the participants experiencing burnout, a greater proportion worked in the catheterization lab compared to the cardiac observation unit (93.8% vs. 6.3%). Burned-out participants worked on average more day shifts, ST-segment elevation myocardial infarction (STEMI) call shifts, and extended day shifts per month compared to those not experiencing burnout. The rate of burnout was significantly higher for individuals reporting increased stress during the pandemic (69% vs. 18%, P < 0.05). CONCLUSIONS: Registered nurses and registered cardiac invasive specialists working in the cardiac catheterization or electrophysiology lab experience elevated levels of burnout. Greater attention should be placed in identifying and optimizing workplace variables which contribute to burnout among this population.

OBJECTIVES: To determine the prevalence of burnout among the midwifery workforce and the association between fixed personal and practice characteristics and modifiable organizational factors, specifically practice environment, to burnout among midwives in the United States. DATA SOURCE: Primary data collection was conducted via an online survey of the complete national roster of certified nurse-midwives and certified midwives over 3 weeks in April 2017. STUDY DESIGN: The study was a cross-sectional observational survey consisting of 95 items about personal and practice characteristics, respondents' practice environments, and professional burnout. DATA COLLECTION METHODS: The inclusion criterion was actively practicing midwifery in the United States. Data were analyzed with bivariate analyses to determine the association between personal and practice characteristics and burnout. A hierarchal multilinear regression evaluated the interrelationship between personal and practice characteristics, practice environment, and burnout. PRINCIPAL FINDINGS: Of the almost one third (30.9%) of certified nurse-midwives and certified midwives who responded to the survey, 40.6% met criteria for burnout. Weak negative correlations existed between burnout and indicators of career longevity: age (r(2256) = −0.09, p < 0.01), years as a midwife (r(2267) = −0.07, p = 0.01), and years with employer (r(2271) = −0.05, p = 0.02). There were significant relationships between burnout score and patient workload indicators: patients per day in outpatient setting (F(5,2292) = 13.995, p < 0.01), birth volume (F(3,1864) = 8.35, p < 0.01), and patient acuity (F(2,2295) = 20.21, p < 0.01). When the practice environment was entered into the model with personal and practice characteristics, the explained variance increased from 6.4% to 26.5% (F(20,1478) = 27.98, p < 0.01). CONCLUSIONS: Our findings suggested that a key driver of burnout among US midwives was the practice environment, specifically practice leadership and participation and support for the midwifery model of care. Structural and personal characteristics contributed less to burnout score than the practice environment, implying that prevention of burnout may be achieved through organizational support and does not require structural changes to the provision of perinatal health.

OBJECTIVE: To examine the prevalence of burnout among radiology trainees in the United States, and to study the relationships between burnout and professional fulfillment (PF), intent-to-leave (ITL), sleep-related impairment and self-compassion by gender. METHODS: This cross-sectional study was conducted via an anonymous electronic survey sent to 11 large academic medical centers (Physician Wellness Academic Consortium) between January 2017 and September 2018. The survey included the Professional Fulfillment Index (PFI) and an abbreviated form of the PROMIS Sleep-related impairment (SRI) scale. Two-sample t-tests and chi-square exact tests were used for analysis (p < 0.05). RESULTS: Two hundred forty-seven radiology residents responded to the survey. Out of these, 36.2% reported burnout, 37.4% endorsed PF, 64.8% reported sleep-related impairment, 7.6% expressed ITL. There were no significant differences between genders. Burnout was associated with reduced PF, increased sleep-impairment (p < 0.001 for both) and increased ITL (p = 0.02). Lower PF, peer support, perceived appreciation for and meaningfulness in work, alignment of organizational and personal values, self-compassion, and higher sleep impairment were associated with burnout (p < 0.001 for all). Burnout was associated with perceptions of less support from department leaders (p = 0.003), control over schedules (p = 0.001) and helpfulness of electronic health record systems (p = 0.01). ITL was associated with reduced PF, perceived work appreciation, and leadership support (p = 0.03, p = 0.04, and p = 0.007, respectively). DISCUSSION: Burnout is prevalent among radiology residents. Many demonstrate sleep-impairment and reduced professional fulfillment, with a lesser fraction desiring to leave their institution. Key factors to burnout included peer and organizational support, electronic health record systems helpfulness, and personal factors like self-compassion and work appreciation.

PURPOSE: To examine the prevalence of burnout, professional fulfillment, sleep impairment, and self-compassion within an academic medical center pharmacy department across varying job titles and practice settings. METHODS: In fall 2019, pharmacy staff completed a REDCap-based survey that consisted of a validated instrument relating to burnout, professional fulfilment, sleep-related impairment, and self-compassion. Burnout was measured by both single-item and extended 10-item questions on the survey. Survey outcomes from each domain were compared between pharmacists and pharmacy technicians/interns, as well as among practice settings (inpatient, ambulatory care, and infrastructure). RESULTS: A total of 593 surveys were completed by pharmacy personnel, representing a preliminary response rate of 71.8% (593/826). A total of 505 survey responses were analyzed (235 [46.5%] for pharmacists and 270 [53.5%] for pharmacy technicians/interns). Inpatient pharmacists reported the highest level of burnout (50.7%), followed by ambulatory care pharmacists (29.3%) and those working in infrastructure (24.3%). Pharmacy technicians working in infrastructure reported the highest level of burnout (36.4%), followed by inpatient (30.8%) and ambulatory care (28.3%) pharmacy technicians. There was no association between job type or location and burnout according to both single-item and 10-item burnout measures. A higher rate of burnout, sleep impairment, and decreased self-compassion and a lower rate of professional fulfillment were observed for inpatient pharmacists compared to pharmacists in ambulatory care or infrastructure. Except for higher rates of reported professional fulfillment, a similar trend was observed for pharmacy technicians. CONCLUSION: Burnout was reported across the pharmacy team regardless of practice site.

Burnout among physicians is a syndrome of emotional exhaustion, de-personalization, and reduced sense of personal accomplishment that can negatively affect personal relationships, physician well-being, and patient outcomes. Although burnout rates of up to 50% to 60% among orthopedic surgeons have been reported, no studies have evaluated burnout among orthopedic generalists and subspecialists. The primary goal of this study was to examine the prevalence of burnout among orthopedic disciplines. We conducted a multicenter study from March 2019 through December 2019 involving 149 orthopedists. An abbreviated Maslach Burnout Inventory-Human Services Survey was used to measure burnout. Demographic information, personal characteristics, professional characteristics, family life and spousal support, and depression were also assessed. The mean rate of burnout among all respondents was 62%, whereas 16.77% screened positive for depression. Subspecialties with the highest rates of burnout were oncology (100%), sports medicine (68%), and trauma (63%). Similarly, trauma (50.00%), oncology (40.00%), and general orthopedics (20.00%) had the highest positive depression screening rates. In contrast, shoulder and elbow (50%), pediatric (52%), and foot and ankle (54%) specialists had the lowest rates of burnout, whereas shoulder and elbow (0.00%), spine (0.00%), and sports medicine (6.50%) specialists had the lowest rates of positive depression screening. Older age, higher debt load, and oncology subspecialty were associated with increased burnout risk. This study sought to determine burnout rates within each orthopedic discipline, with a secondary aim of disclosing contributing factors. Trauma and oncology had the highest rates of burnout and positive depression screening. Because this study represents a small orthopedic cohort, larger studies are needed to appropriately manage burnout in the future.

[This is an excerpt.] The ongoing COVID-19 pandemic has led to significant burnout in all healthcare professionals. Burnout can be defined as a state of mental and emotional weariness, characterized by feelings of energy depletion or exhaustion, depersonalization, and a lack of accomplishment on a personal level.1 It is anticipated that the burnout amongst Canadian radiologists has increased from the 72% that experienced emotional exhaustion in the 2017 national survey. Exacerbation of preexisting systemic issues due to the COVID-19 pandemic, increased domestic responsibilities, fluctuating imaging volumes, increasingly complex patients, and emerging pressures including Radiology’s environmental responsibility and integration of artificial intelligence, are contributing to increasing burnout. [To read more, click View Resource.]

OBJECTIVE: Due to the COVID-19 pandemic, burnout among healthcare workers has significantly increased. This study evaluated rates of burnout in neuropsychologists one year into the COVID-19 pandemic. METHOD: A survey invitation was sent across five neuropsychology-related listservs in April 2021. Burnout was assessed with the Copenhagen Burnout Inventory (CBI; Kristensen, T. S., Borritz, M., Villadsen, E., & Christensen, K. B. (2005). The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work & Stress, 19 (3), 192–207) and differences in Personal, Work, and Client burnout scores were evaluated across patient population and work setting. RESULTS: 57.3% and 51.5% of respondents (N = 130) endorsed moderate-to-high levels of personal and work-related burnout, respectively. In the Personal domain, respondents working with pediatric patients had higher mean scores and a higher proportion of respondents endorsed moderate-to-high levels of burnout. CONCLUSION: More than half of the survey respondents endorsed elevated levels of personal and work-related burnout. This is concerning as burnout is associated with personal challenges and diminished patient care. Potential organizational interventions are discussed.

BACKGROUND: A telephone support hotline (PSU-HELPLINE) was established at the beginning of the pandemic due to the burden on health professionals and the lack of support at the workplace. The aim of this study was to evaluate the telephone support service for health professionals in terms of its burden, benefits, and mechanisms of action. METHODS: Data collection was conducted during and after calls by PSU-HELPLINE counsellors. In addition to the socio-demographic data evaluation, burdens of the callers and the benefits of the calls were collected. The content-analytical evaluation of the stresses as well as the effect factors were based on Mayring’s (2022). RESULTS: Most of the callers were highly to very highly stressed. The usefulness of the conversation was rated as strong to very strong by both callers and counsellors. The PSU-HELPLINE was used primarily for processing serious events and in phases of overload. The support work was carried out through the following aspects of so-called effect factors, among others: psychoeducation, change of perspective, resource activation, problem actualization, connectedness, information, problem solving, self-efficacy, and preservation of resources. CONCLUSIONS: The expansion of local peer support structures and the possibility of a telephone helpline are recommended. Further research is needed.

A humanistic, personal, empathic, and patient-centered attitude towards the patient and family during the clinical encounter is often neglected in many settings. However, patients give it an utmost priority; moreover, the Institute of Medicine stressed it as a fundamental approach to improve the quality of care in the US, and the potential benefits accrued by its implementation are substantial. These benefits encompass patients (including increased satisfaction, trust, adherence, and ‘hard’ health outcomes), physicians (including rediscovering meaning and escaping burnout), and health care systems. Highlighting the quintessential value of humanism and patient-centeredness in the encounter, we discuss the cornerstones of adopting a 'personal' attitude that requires sincere friendly 'connecting' to the patient which can be accomplished with little loss of time, and their myriad advantages, to motivate clinicians to be more mindful of the patient and his or her circumstances.

BACKGROUND: Empathic erosion and burnout represent crises within medicine. Psychological training has been used to promote empathy and personal resilience, yet some training useful within adjacent fields remain unexplored, e.g., Stoic training. Given recent research within psychology suggesting that Stoic training increases emotional wellbeing, exploring this type of training within health professions education is important. We therefore asked: What impact would a Stoicism informed online training package have on third year medical students’ resilience and empathy? METHODS: 24 third year medical students took part in 12 days of online training (SeRenE), based on Stoic philosophy, and co-developed with psychotherapists. A mixed-methods study was conducted to evaluate impact. Pre- and post-SeRenE students completed the Stoic Attitudes and Behaviours Scale (SABS), Brief Resilience Scale (BRS) and Jefferson Scale of Empathy (JSE). All students completed semi-structured interviews following training and 2 months post-SeRenE. Thematic analysis was employed to analyse qualitative data, whilst within subjects t-tests and correlational analyses were conducted on quantitative data. RESULTS: Quantitatively, stoic ideation, resilience and empathy increased post-training, with correlational analyses suggesting resilience and empathy increase in tandem. Qualitatively, four themes were identified: 1. Negative visualisation aids emotional and practical preparedness; 2. Stoic mindfulness encourages students to think about how they think and feel; 3. Stoic reflection develops the empathic imagination; and 4. Evaluating the accessibility of SeRenE. CONCLUSIONS: Our data lend support to the ability of Stoic-based psychological training to positively influence resilience and empathy. Although, quantitatively, results were mixed, qualitative data offers rich insight. The practice of negative visualisation, promoted by SeRenE, encourages student self-efficacy and planning, domains of resilience associated with academic success. Further, this study demonstrates a connection between Stoic practice and empathy, which manifests through development of the empathic imagination and a sense of empathic bravery.

PURPOSE: Interdisciplinary training is a critical part of pharmacy education, and often much of the interdisciplinary participation occurs during the advanced practice experiences of the final professional year of pharmacy education. Creation and maintenance of these experiences can be difficult for faculty members, especially faculty at community hospitals or those with multiple roles and responsibilities at their practice site. The purpose of this article is to reflect on the development process and student acceptance of a collaborative, three-day a week internal medicine rounding student experience. DESCRIPTION: Instead of a traditional five-day a week rounding schedule with a single, primary faculty preceptor, students participated in a three-day a week internal medicine rounding experience where their primary faculty preceptor had a faculty partner who functioned as a substitute. The student activities on the other days were adapted by each faculty preceptor based on their internal medicine subspecialty duties and needs of the practice site. ANALYSIS/INTERPRETATION: Results from a seven-question, anonymous survey to students who participated in the three-day a week internal medicine rounds found high impact on their reported confidence and knowledge. Those responding "positive impact" or "extreme positive impact" ranged from 67% to 100%. In addition, 78% indicated comfort with the substitute faculty preceptor. CONCLUSIONS: This collaborative, three-day a week rounding experience was well received by pharmacy students. IMPLICATIONS: Non-traditional rounding may be an option that could help decrease pharmacy student and faculty burnout, while still providing a positive learning experience for students.

Secondary traumatic stress (STS) is the emotional duress caused by indirect exposure to distressing events experienced by others. Health care providers are particularly susceptible to secondary stress due to regular exposure to difficult and painful clinical situations that evoke intrinsic empathy necessary to provide effective care. Understanding STS as a normal stress response not only helps to make sense of the symptoms but also suggests a way forward. Opportunities for those in health care to address STS can be found among our colleagues and in our own settings and may provide a meaningful source of support if accessed effectively.

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic globally impacted healthcare due to surges in infected patients and respiratory failure. The pandemic escalated nursing burnout syndrome (NBS) across the workforce, especially in critical care environments, potentially leading to long-term negative impact on nurse retention and patient care. To compare self-reported burnout scores of frontline nurses caring for COVID-19 infected patients with burnout scores captured before the pandemic and in non-COVID-19 units from two prior studies. METHODS: The descriptive study was conducted using frontline nurses working in eight critical care units based on exposure to COVID-19 infected patients. Nurses were surveyed in 2019 and in 2020 using Maslach Burnout Inventory (MBI), Well Being Instrument, and Stress-Arousal Adjective Checklist (SACL) instruments. Researchers explored relationships between survey scores and working in COVID-19 units. RESULTS: Nurses working in COVID-19 units experienced more emotional exhaustion (EE) and depersonalization (DP) than nurses working in non-COVID units (p= .0001). Pre-COVID nurse burnout scores across six critical care units (EE mean = 15.41; p= .59) were lower than burnout scores in the COVID-19 intensive care units (EE mean = 10.29; p= .74). Clinical significance (p= .08) was noted by an EE subscale increase from low prepandemic to moderate during the pandemic. CONCLUSION: Pinpointing associations between COVID-19 infection and nurse burnout may lead to innovative strategies to mitigate burnout in those caring for the most critically ill individuals during future pandemics. Further research is required to establish causal relationships between sociodemographic and work-related psychological predictors of NBS.

BACKGROUND: As the field of palliative care continues to grow, many clinicians will care for patients with whom they have personal connections. Breaching the boundary between a clinician's personal and professional life is potentially an unrecognized risk for burnout. OBJECTIVE: We explored the challenges of caring for patients personally known to clinicians and the types of support needed, with a view to developing preliminary practice guidelines. DESIGN: Focus groups. Setting/Subjects: Thirteen psychosocial oncology and palliative care clinicians who care for adult patients participated in one of two focus groups. Six participants were physicians, four were nurse practitioner/registered nurse/physician assistant (NP/RN/PAs), and three were psychosocial clinicians. MEASUREMENT: Using NVivo 12, we analyzed focus group transcripts from clinicians about their experiences caring for patients they know personally, the impact of such experiences, and the type of support and guidelines that could benefit clinicians in these unique situations. RESULTS: Navigating boundaries and managing the psychological impact on the clinician, including fear of negative evaluation, increased anxiety and emotional exhaustion were the most challenging aspects of providing such care. Suggested guidelines include an early team meeting, a buddy system, a conversation guide to address the dual relationship, and embedded psychological support and mentorship. CONCLUSIONS: Feedback from clinicians identified preliminary guidelines that incorporate tools palliative care teams can use to improve support for clinicians caring for patients with whom they have a personal connection. These tools address the psychosocial aspects of care and have the potential to help clinicians feel a greater sense of control in these often, challenging and emotionally taxing situations.

According to the Bureau of Labor Statistics (BLS), as of June 2022, hospitals are down 65,000 employees from February 2020. NAVIGATING THE CHALLENGES To address the magnitude of this problem, the AHA Board of Trustees' Task Force on Workforce and the International Association for Healthcare Security & Safety developed a report titled Creating Safer Workplaces: A Guide to Mitigating Violence in Health Care Settings (www.aha.org/workplace-violence). Aspen Valley Hospital in Colorado provides quiet rooms for staff to use for “time outs” from stressful situations; Hackensack Meridian Health in New Jersey offers educational classes and training on stress management; Cody Regional Health in Wyoming has on-site access to licensed therapists for emotional support; and in Delaware, ChristianaCare's new Center for WorkLife Wellbeing, physicians can share and process traumatic experiences. To this end, we are partnering with a coalition of stakeholders on a workforce agenda focusing on: lifting the cap on Medicare-funded physician residencies, boosting support for nursing schools and faculty, providing scholarships and loan repayment for certain providers, and expediting visas for all foreign highly trained healthcare personnel; supporting efforts to bolster nursing faculty to ensure that hospitals have the nurses they need in the future (schools turned away more than 90,000 qualified applicants from baccalaureate and graduate programs in 2021 alone due to an insufficient number of faculty, clinical sites, and classrooms according to the American Association of Colleges of Nursing, 2022); establishing a Rural America Health Corps modeled on the National Health Service Corps to encourage healthcare professionals to serve in rural areas; extending and expanding the Conrad State 30 J-1 visa waiver program, which waives the requirement to return home for a period if physicians holding J-1 visas agree to stay in the United States for 3 years to practice in a federally designated underserved area; encouraging Congress to support bipartisan legislation, such as the SAVE Act, to protect healthcare workers against workplace violence; increasing regulatory oversight of nurse staffing agencies to deal with price gouging and anticompetitive behavior that exploits the pandemic by charging hospitals exorbitant prices for contract workers (legislation pending on Capitol Hill would require an independent review of these practices); supporting states' efforts to expand the scope of practice laws allowing healthcare professionals to practice at the top of their licenses; and stopping health insurers' burdensome practices that take caregivers away from the bedside and increase burnout and turnover. [...]the AHA was proud to support and obtain funding for the new Dr. Lorna Breen Health

Occupational health and safety programmes aim to prevent diseases and injuries arising out of, linked with or occurring in the course of work, while improving the quality and safety of care, safeguarding the health workforce and promoting environmental sustainability in the health sector.

This guide provides an overview of the key elements of occupational health and safety programmes for health workers at national, subnational and facility levels, as well as advice for the development and implementation of such programmes.

This resource is found in our Actionable Strategies for Health Organizations: Ensuring Physical & Mental Health (Occupational Safety) AND Ensuring Workers' Physical and Mental Health (Strengthen Occupational Safety and Health Policies).

Suicide is the most common cause of death in male resident physicians and the second most common cause of death in resident physicians overall. Physicians also experience high rates of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and burnout. These conditions frequently develop during medical school, and threaten not only physicians but the patients they care for. A 30-year-old medical student presented to our clinic with a history of treatment-resistant depression (TRD), generalized anxiety disorder (GAD), PTSD, and 5 years of daily suicidal ideation. Previous treatments included therapy, lifestyle modifications, and various combinations of six antidepressants. These interventions had little effect on the patient's mental health. The patient was treated at our clinic with an 8-month regimen of IV ketamine infusions and ketamine-assisted psychotherapy (KAP). The patient achieved remission from suicidality and PTSD within 1 month; and TRD and GAD within 7 months. The patient's Patient Health Questionnaire (PHQ-9) score decreased from 25 (severe depression) to 1 (not depressed). These findings suggest that ketamine and KAP may represent effective interventions for mental health applications in healthcare professionals. The patient made the unique decision to attempt to type narrative journals during four of his ketamine infusions (doses ranged from 1.8 to 2.1 mg/kg/h IV). The patient successfully typed detailed journals throughout each 1-h ketamine infusion. To our knowledge, these journals represent the first independently typed, first-person, real-time narratives of ketamine-induced non ordinary states of consciousness. The transcripts of these journals may provide useful insights for clinicians, particularly in the context of KAP.

Diversity, equity, and inclusion (DEI) is a framework used to promote high performance teams, prioritizing principles of justice and intersectionality. There is abundant evidence that members of marginalized communities, such as racial and ethnic minorities and sexual and gender minorities, experience higher threats to well-being than members of dominant groups. Such threats include systemic racism and discrimination, bias, sexism, and homophobia, all of which are deeply ingrained in medical culture. Recognizing and responding to these threats requires an understanding of how individual identities influence interactions in the workplace, including evaluations and promotions, team dynamics, and career trajectory. Discrimination and bias are known contributors to adverse outcomes in emotional and physical health, career satisfaction, and social connectedness in the workplace. Any effort to promote well-being and decrease burnout must center DEI as a foundational component of that effort, or risk further marginalization of certain groups and likely failure of the intervention.

OBJECTIVE: To evaluate the prevalence of burnout and satisfaction with work-life integration (WLI) in US physicians at the end of 2021, roughly 21 months into the COVID-19 pandemic, with comparison to 2020, 2017, 2014, and 2011. METHODS: Between December 9, 2021, and January 24, 2022, we surveyed US physicians using methods similar to our prior studies. Burnout, WLI, depression, and professional fulfillment were assessed using standard instruments. RESULTS: There were 2440 physicians who participated in the 2021 survey. Mean emotional exhaustion and depersonalization scores were higher in 2021 than observed in 2020, 2017, 2014 and 2011 (all Journal Pre-proof p<.001). Mean emotional exhaustion scores increased 38.6% (2020 mean=21.0; 2021 mean=29.1; p<.001) while mean depersonalization scores increased 60.7% (2020 mean=6.1; 2021 mean=9.8; p<.001). Overall, 62.8% of physicians had at least one manifestation of burnout in 2021 compared with 38.2% in 2020, 43.9% in 2017, 54.4% in 2014, and 45.5% in 2011 (all P<.001). While these trends were consistent across nearly all specialties, substantial variability by specialty was observed. Satisfaction with WLI declined from 46.1% in 2020 to 30.2% in 2021 (P<.001). Mean scores for depression increased 6.1% (2020 mean=49.54; 2021 mean=52.59; p<.001). CONCLUSION: A dramatic increase in burnout and decrease in satisfaction with WLI occurred in US physicians between 2020 and 2021. Differences in mean depression scores were modest suggesting the increase in physician distress was overwhelmingly work-related. Given the association of physician burnout with quality of care, turnover, and reductions in work effort, these findings have profound implications for the US healthcare system.