Increased Levels of Stress and Burnout Are Related to Decreased Physician Experience and to Interventional Gastroenterology Career Choice: Findings from a US Survey of Endoscopists

Objectives: Physician stress and burnout can decrease job satisfaction, increase medical errors, and reduce quality of life. Gastrointestinal endoscopic practice is increasing in complexity, with an associated increase in complications. These factors may result in more stress and burnout in younger gastroenterologists (GEs) and interventional GEs (IGEs) who perform more complex endoscopic procedures. We aimed to create a valid measure of GE endoscopic practice stress and to evaluate stress and burnout related to endoscopist experience and IGE versus non-IGE practice.

Methods: We used both a qualitative and a cross-sectional correlation design. Semistructured interviews were conducted and thematically coded to create a measure of stressors in GE practice, the Gastroenterologist Stress Inventory (GESI). Gastroenterology fellows and attending physicians were approached to participate. Four GEs were interviewed, and 489 completed the online survey. Endoscopists completed the Maslach Burnout Inventory, the GESI, and demographic, training, and practice data.

Results: The GESI met reliability standards. Junior IGEs and junior non-IGEs reported more stress related to endoscopic practice than senior attendings. All GEs reported moderate levels of burnout; decreased physician experience was a predictor of burnout for IGEs.

Conclusions: GEs report moderate levels of stress and burnout. IGEs and those who have experienced an endoscopic complication report significantly more stress. Less experience is related to more stress and burnout, with junior IGEs reporting the highest levels.