JOURNAL REVIEW

Universal issues lead to pharmacist burnout

Practicing at an HMO earns high marks

Gupchup, et al. Burnout in sample of HMO pharmacists using the Maslach Burnout Inven tory. J Managed Care Pharm 1998; 4:495-503.

Workload and staff levels, relationships with supervisors, years in the same job, family and money. For HMO pharmacists, these universal issues largely determine levels of job-related burnout, though some unique variables such as career aspirations and the amount of clinical work being done also figure into the equation.

And burnout does exist, according to a detailed survey of 83 HMO pharmacists from practices in 38 states, conducted by pharmacists at the University of New Mexico College of Pharmacy in Albuquerque.

To cross-reference and construct profiles of staff burnout levels and indicators, the study’s authors used the established Maslach Burnout Inventory System, which measures burnout in terms of "emotional exhaustion," "depersonalization," and "reduced personal accomplishment," matched then with demographics, job-specific variables, and career aspirations. It’s a survey the authors say is unique; only one other self-reported burnout survey was unearthed, one that asked just four questions of HMO pharmacists in one regional Kaiser facility.

Here pharmacists were asked to weigh answers to 22 questions in three categories, and to provide detailed personal demographics.

Overall, 89.9% of respondents worked in an outpatient setting, 92.8% held supervisor roles, 64.6% worked from 41 to 50 hours a week, and 59.8% spent up to a quarter of their time processing prescriptions.

In terms of overall burnout findings, higher levels of burnout responses were found in the categories of emotional exhaustion and depersonalization, while lower burnout levels were found in personal accomplishment scores, leading the authors to believe the pharmacists are proud of the job they are doing. Another general finding was that if you want to be a happy pharmacist, get married, have kids, and make more than $60,000 a year.

Specifically, within the three survey categories, beginning with emotional exhaustion, results found that marital status and annual salary played large roles in pharmacist happiness, with those not married and making $49,999 or less scoring higher levels of emotional exhaustion then their married, better compensated counterparts. Also within this category, supervisory pharmacists suffered less than staff pharmacists, while the greater number of years spent on the job increased burnout across the board.

The same held true in the depersonalization category in terms of marital status and income. In the category of personal accomplishment, the noteworthy result was that pharmacists working longer hours actually scored better on personal accomplishment questions than those working less. Specifically the scores were better for those working 35 to 40 hours a week vs. those working 34 hours or fewer.

Pharmacists desire more clinical duties

Predictably, the pharmacists said that overtime pay, increased patient counseling, and direct clinical duties such as drug utilization management, formulary development, and patient care would make them happier in their jobs. Likewise, the authors posit that more control over the practice, constructive supervisory feedback and better-run policies and procedures are equally important.

On the positive side, the majority of respondents did note that "working in the HMO setting is more satisfying than working in other practice settings."

So what can be done about, or with, all this information? The authors advocate specific, tailor-made stress management programs based on the specific demographics that affected burnout. "This would avoid the common pitfall of many stress management programs that attempt to treat everybody identically," notes Gupchup.

[Editor’s note: For more information or reprints, contact Gireesh V. Gupchup, PhD, Assistant Professor of Pharmacy, University of New Mexico College of Pharmacy, Albuquerque, NM 87131. Telephone: (505) 277-6306.]