Understanding Burnout in ER Doctors: The Role of Thinking Preferences

Burnout rates among physicians almost doubled. Is it the hours? The stress? Or something else entirely?

Naghma Khan is an emergency room (ER) doctor. She’s seen a lot in the last few years. One thing she’s seen a lot of is doctor burnout. Doctors are struggling.

Khan wasn’t the only one to notice. In the winter of 2022, the American Medical Association (AMA) joined with the Mayo Clinic, Stanford and the University of Colorado to survey nearly 2,500 U.S. physicians. The researchers found that 62.8% of physicians experienced at least one manifestation of burnout in 2021, compared with 38.2% in 2020.

Khan wanted to look deeper. In addition to her work as a pediatric emergency medicine physician, she was pursuing a graduate degree in Creativity and Change Leadership at the State University of New York - Buffalo State. She decided to focus her graduate thesis on physician burnout. 

Could thinking preferences connect to burnout? 

Gerard Puccio PhD, chair of the department, was Khan’s advisor. When she proposed to study the correlation between thinking profiles and burnout, even Puccio, the author of the FourSight Thinking Profile, was skeptical. “To be honest, I wasn’t confident we would find anything,” he admitted. “How would thinking preferences impact burnout?”

But Khan had a hunch. She studied 76 pediatric ER docs, giving them both the FourSight Thinking Profile assessment and a well-respected assessment on physician burnout. Then she analyzed the data. 

What she found didn’t surprise her, but it astonished Puccio. He had assumed that the strongest predictor of burnout would be job characteristics, like hours worked per week or years worked in the profession. It was not. While the job characteristics contributed to burnout, the strongest predictor of physician burnout was a high preference to clarify.

“I was blown away,“ said Puccio. "I would never have imagined that someone’s thinking preference could have that kind of central impact on their work experience.“

Why ER docs?

Khan shared her logic. In the fast paced, chaotic environment of an emergency room, she explained, doctors never have all the information they need to feel absolutely comfortable moving forward. They have to work quickly with limited information. That’s excruciating for high clarifiers, whose natural instinct is to gather every piece of information and think through every possible consequence before making a move. There’s simply no time for that in the ER. They can never satisfy that need.

Stress is often defined as any type of change that causes physical, emotional or psychological strain. Stress can lead to burnout. Doctors in the ER work in a constantly changing environment where information is limited. That is more likely to stress high clarifiers than other types of thinkers. Khan suspected she might find something like this in the study. It was gratifying that she did.

Do you struggle with burnout?

Consider the nature of your work. Do your daily tasks line up well with your thinking profile? Or do the demands of your work constantly short-circuit your cognitive needs, creating undue stress?

Look for an upcoming newsletter where we pursue the flip side of burnout: the thinking preference that helps people stay identified with their higher calling.

Learn more about Khan's study...

• Read Naghma Khan’s study.
• Listen to Gerard Puccio PhD present the findings in a 55-minute FourSight U* on ER Doctors and Burnout. (FourSight U is our free monthly webinar for certified facilitators.) 

Contribute to the research.

FourSight is hoping to do more studies in the area of thinking preference and burnout. Let us know if you might be interested in pursuing another academic research study to extend this initial finding.