BACKGROUND AND PURPOSE:

• Work overload among health care providers during and following the COVID-19 pandemic resulted in burnout and further staffing shortages
• Rotenstein et al. (JAMA Internal Medicine, 2025) assessed the prevalence of incompletely staffed teams and its association with burnout and work intentions of US physicians

METHODS:

• Cross-sectional study
  • December 13, 2022 to March 31, 2025
  • Data derived from AMA Organizational Biopsy tool
• Population
  • Physicians who responded to questions related to team staffing
• Exposures
  • Self-reported incomplete staffing
• Study design
  • Multivariable logistic regression models were used to assess the association of incomplete team staffing >25% of the time with primary outcomes
  • Adjustments: Years in practice | Gender | Race and ethnicity | Part-time vs full-time | Specialty grouping | Practice setting
• Primary outcome
  • Burnout: Assessed with the Mini Z’s single-item burnout measure (rate level of burnout from 1 to 5)
  • Career intentions
    • Self-reported intent to reduce clinical working hours (ITR)
    • Self-reported intent to leave workforce (ITL)

RESULTS:

• 970 physicians | 15 organizations
  • Women: 43.4% | Full-time: 67.2% | Outpatient setting only: 64.4%
• Nearly half of respondents reported working with an incompletely staffed team >25% of the time
  • Overall: 47.9%
  • Primary care: 44.8%
  • Medical: 38.5%
  • Surgical: 49.3%
  • Other: 62.4%
• Respondents who met criteria for burnout: 47.9%
• Respondents who indicated likely or definite ITR in next 12 months: 26.4%
• Respondents who indicated likely or definite ITL in next 24 months: 15.4%
• Working with an incompletely staffed team more than 25% of the time was associated with greater prevalence of
  • Burnout
    • Incomplete: 61.1% | Not incomplete: 35.8% | P<0.001
    • Adjusted odds ratio (aOR) 2.21 (95% CI, 1.59 to 3.06)
  • ITR
    • Incomplete: 31.2% | Not incomplete: 22.0% | P<0.001
    • aOR 1.43 (95% CI, 1.01 to 2.03)
  • ITL
    • Incomplete: 18.1% | Not incomplete: 12.9% | P<0.02
    • aOR 1.49 (95% CI, 1.07 to 2.34)

CONCLUSION:

• US Physicians commonly report incomplete staffing following the pandemic
• Working with an incompletely staffed team was associated with higher rates of burnout, intention to reduce hours, and intention to leave the health care workforce
• The authors state

The cross-sectional nature of the study does not allow us to infer causation

Future studies should test policies and interventions that facilitate sustainable and robust staffing of health care teams

Learn More – Primary Sources:

Incomplete Team Staffing, Burnout, and Work Intentions Among US Physicians