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Understanding the Origins and Factors of Burnout in Physical Medicine and Rehabilitation: A Grounded Theory Analysis
Robert Simpson;
Eva Cohen;
Stephanie Posa;
Marina Wasilewski;
Anthony Feinstein;
Mark Bayley;
Larry Robinson;
Sarah Munce;
Carolyn Steele-Gray;
Kristina Kokorelias
ABSTRACT
Background:
Physician burnout is highly prevalent in Physical Medicine and Rehabilitation (PM&R), but its origins and drivers remain poorly understood.
Objective:
This study explores the factors contributing to burnout among Canadian physiatrists.
Methods:
Using Charmaz’s Constructed Grounded Theory within a qualitative interpretivist paradigm, we interviewed 30 Canadian physiatrists about their experiences with burnout. Analysis was informed by Cooley’s Looking Glass Self theory.
Results:
Burnout in PM&R stems from a medical culture prioritizing academic excellence over compassionate care. Physiatrists report shame and self-criticism when unable to meet these high standards. Burnout peaks during residency, where autonomy is low and demands are high. Participants also described feeling unprepared to handle patients' emotional needs and experiencing moral distress when necessary care cannot be delivered due to systemic barriers. Healthcare bureaucracy further compounds burnout.
Conclusions:
Addressing burnout in PM&R requires upstream systemic and contemporary cultural change.
Citation
Please cite as:
Simpson R, Cohen E, Posa S, Wasilewski M, Feinstein A, Bayley M, Robinson L, Munce S, Steele-Gray C, Kokorelias K
Understanding the Origins and Factors of Burnout in Physical Medicine and Rehabilitation: Grounded Theory Analysis