Positive and negative work characteristics associated with burnout among primary care pediatricians

Background: There is little research regarding specific work features that might cause chronic stress and burnout among primary care pediatricians. The aim of the present study was first, to assess specific negative and positive characteristics of the job that might be related to burnout; and second, to compare burnout levels and work characteristics among board-certified versus general pediatricians; and clinic directors versus non-directors. Methods: Questionnaires were sent to 200 pediatricians employed full-time in pediatric primary care community centers in the largest Israeli Health Maintenance Organization (HMO). Respondents replied anonymously. The questionnaires assessed sociodemographic details, burnout levels, and negative and positive job characteristics. Results: There were no differences in burnout levels between board-certified and general pediatricians. Positive job features had stronger associations with burnout than negative features. Compared with general pediatricians, board-certified pediatricians reported significantly higher levels of negative features (e.g. conflicts between the medical and administrative system in the HMO; parents disregarding instructions); but higher levels of autonomy and appreciation from patients. Compared with regular pediatricians, clinic directors had significantly higher levels of negative job features (e.g. less access to resources); and higher levels of positive work features. Conclusions: The absence of positive job features (e.g. autonomy, recognition for one's work and utilization of skills) may be more important in causing burnout than the presence of negative characteristics (e.g. overload, demanding and noisy parents). It is consistent with recent suggestions that in the presence of positive features, employees can better tolerate stressful aspects of the job and still feel motivated and engaged.