Pediatric Emergency Physician Burnout During the COVID-19 Pandemic: The Effect of Perfectionism

Martin, S. R.; Heyming, T. W.; Piroutek, M.; Kain, Z. N.

Study Objectives: Emergency physicians are at risk of experiencing burnout and the COVID-19 pandemic may exacerbate this risk. Perfectionistic characteristics are common among physicians and recent work suggests that perfectionism may play a role in physician burnout. The current study aims were to assess the prevalence of burnout among pediatric emergency medicine physicians (PEMP) during the COVID-19 pandemic and examine the effects of demographics and perfectionism on burnout. Methods: Participants included 20 attending PEMP (50% female) within a children’s hospital. Participants completed self-report behavioral instruments between August 2020 and February 2021. Perfectionism was assessed via the Socially Prescribed (ie, beliefs that others impose unrealistic standards) and Self-Oriented Perfectionism (ie, high self-standards) subscales of the Big Three Perfectionism Scale. Emotional Exhaustion, Depersonalization, and Personal Accomplishment Burnout levels were assessed via the Maslach Burnout Inventory. Mean difference and logistic regression analyses were conducted. Results: In this sample, 5% of PEMP endorsed high levels of emotional exhaustion and personal accomplishment burnout, and 35% reported high levels of depersonalization burnout. Demographic factors were not associated with burnout. PEMP who endorsed high depersonalization burnout also reported significantly higher levels of socially prescribed perfectionism (11.14 vs. 8.00, Z =-2.02, p =.028). The odds of experiencing high depersonalization burnout was 1.64 (95% CI 1.05-2.54) higher with each unit increase in socially prescribed perfectionism ( X 2 =6.39, p =.012). No other factors were associated with burnout. Conclusion: During the COVID-19 pandemic, 35% of PEMP reported high levels of depersonalization burnout, which reflects interpersonal detachment from patients and peers. Socially prescribed perfectionism was the only PEMP characteristic associated with burnout. Collectively, results suggest that stronger beliefs that others expect perfect performance may have contributed to interpersonal detachment while navigating stressors during the pandemic. Future work in larger PEMP samples is needed to confirm the current findings and address individual and system-level factors that may promote detrimental perfectionistic expectations.