By Stacey Kusterbeck, Author, Relias Media

The vast majority of clinicians (91%) felt they’d personally provided futile or potentially inappropriate care to a patient in the previous six months, found a recent study.

Moreover, about 35.5% of respondents said they’ve considered leaving their job because of it. “The aim of this study was to quantify how often clinicians believe they provide futile or potentially inappropriate care, and to determine correlations between such care and measures of clinician wellness,” says lead author Jason Lambden, an MD candidate at New York City-based Weill Cornell Medicine.

Researchers surveyed 349 clinicians at two New York City hospitals in the fields of internal medicine, surgery, neurology, or intensive care, looking at outcomes of clinician burnout, clinician depression, and intention to quit. Some key findings with important implications for clinician wellness include:

  • 43.4% screened positive for burnout syndrome.
  • 7.8% screened positive for depression.
  • The amount of perceived futile or potentially inappropriate care provided was significantly associated with burnout and thoughts of quitting.

This held true regardless of experience, position, department, and the number of dying patients cared for. “This suggests that the greater the amount of futile or potentially inappropriate care you believe you provide, the more likely you are to experience burnout and to think about quitting,” says Lambden.

The study’s findings have important implications for clinician wellness, which is a growing concern in health care. The National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience aims to raise awareness of the issue and identify evidence-based, multidisciplinary solutions. 

Notably, most of the perceived futile care stemmed from disagreements about goals of care at the end of a patient’s life. Thus, Lambden recommends hospitals focus their efforts on improving communication among clinicians and families. Disagreements regarding care aren’t always able to be reconciled. “But it is important to recognize the toll that this can take on clinicians,” says Lambden.

Look for more coverage and analysis of the study in the upcoming February issue of Medical Ethics Advisor.