Resilience and Burnout Among Physicians and the General US Working Population

JAMA Netw Open. 2020 Jul 1;3(7):e209385. doi: 10.1001/jamanetworkopen.2020.9385.


Importance: The prevalence of physician burnout is well documented, and resilience training has been proposed as an option to support physician well-being. However, the resilience of physicians compared with that of the US working population is not established, and the association between resilience and physician burnout is not well understood.

Objectives: To evaluate resilience among physicians and US workers, and to determine the association between resilience and burnout among US physicians.

Design, setting, and participants: A cross-sectional national survey study of 5445 US physicians and a probability-based sample of 5198 individuals in the US working population was conducted between October 12, 2017, and March 15, 2018.

Main outcomes and measures: Resilience was measured using the 2-item Connor-Davidson Resilience Scale (total scores range from 0-8; higher scores indicate greater resilience); burnout was measured using the full Maslach Burnout Inventory with overall burnout indicated by a score of at least 27 on the 0 to 54 emotional exhaustion subscale and/or at least 10 on the depersonalization subscale (higher scores indicate greater burnout).

Results: Of 30 456 physicians who received an invitation to participate, 5445 (17.9%) completed surveys (2995 men [62.1%]; median [IQR] age of 53 [42-62] years). In multivariable analysis, mean (SD) resilience scores were higher among physicians than the general employed population (6.49 [1.30] vs 6.25 [1.37]; adjusted mean difference, 0.25 points; 95% CI, 0.19-0.32; P < .001). Among physicians, resilience was associated with burnout. Physicians without overall burnout had higher mean (SD) resilience scores than physicians with burnout (6.82 [1.15] vs 6.13 [1.36]; adjusted mean difference, 0.68 points, 95% CI, 0.61-0.76; P < .001). Each 1-point increase in resilience score was associated with 36% lower odds of overall burnout (odds ratio, 0.64; 95% CI, 0.60-0.67; P < .001). However, 392 of 1350 physicians (29%) with the highest possible resilience score had burnout.

Conclusions and relevance: The findings of this national survey study suggest that physicians exhibited higher levels of resilience than the general working population in the US. Resilience was inversely associated with burnout symptoms, but burnout rates were substantial even among the most resilient physicians. Additional solutions, including efforts to address system issues in the clinical care environment, are needed to reduce burnout and promote physician well-being.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Burnout, Professional* / diagnosis
  • Burnout, Professional* / epidemiology
  • Burnout, Professional* / prevention & control
  • Burnout, Professional* / psychology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Mental Health / statistics & numerical data
  • Middle Aged
  • Needs Assessment
  • Physicians* / psychology
  • Physicians* / statistics & numerical data
  • Prevalence
  • Resilience, Psychological*
  • United States / epidemiology
  • Workplace* / psychology
  • Workplace* / standards