A cross-sectional analysis of compassion fatigue, burnout, and compassion satisfaction in maternal -fetal medicine physicians in the United States

BACKGROUND: Compassion fatigue is secondary traumatic distress experienced by providers from ongoing contact with patients who are suf-fering. Compassion satisfaction is emotional fulfillment from caring for others. Burnout is distress related to dissonance between job demands and available resources. Although burnout is well-studied, compassion satisfaction and compassion fatigue are neglected components of physi-cian well-being. Because of recurrent exposure to adverse outcomes, maternal-fetal medicine providers may be at particular risk for compas-sion fatigue.OBJECTIVE: This study aimed to better characterize both clinical and nonclinical drivers of work-related distress vs satisfaction.STUDY DESIGN: The modified Compassion Fatigue and Satisfaction Self-Test and a questionnaire of professional and personal characteristics were distributed electronically to maternal-fetal medicine providers nationally. Multivariable regression models were constructed for compas-sion fatigue, burnout, and compassion satisfaction as a function of poten-tial predictors.RESULTS: The survey response rate was 24% (n=366), primarily con-sisting of White physicians working in academic medical centers. Significant predictors of lower burnout scores included employment at 1 institution for >20 years, discussing work-related distress with friends, and having one's most recent involvement in decision-making for a perivi-able fetus >6 months ago; distress because of coworkers and personal factors predicted higher scores. Female sex, self-report of significant emo-tional depletion, use of mental health services, and having other maternal -fetal medicine physicians as part of the care team for a fetus with severe anomalies were significant predictors of higher compassion fatigue scores, whereas White race and having social work as part of the care team for a maternal mortality predicted lower scores. Personal spiritual practice was a significant predictor of higher compassion satisfaction score, whereas employment at current institution for <5 years predicted lower scores.CONCLUSION: Compassion fatigue, compassion satisfaction, and burnout are associated with several modifiable risk factors, such as prac-tice type, having a multidisciplinary team, and emotional support outside of the workplace; these are potential targets for intervention.