Table 2

Major emerging themes and associated key quotes for organisational factors that drive burnout

Major themeKey quotes
Interruptions and noise
  • Ex 1. “The number of times my phone rings in a day and the number of thoughts that gets interrupted and conversations that get interrupted, that I that is really something that takes energy away from me rather than giving value.” (GIM)

  • Ex 2. “The other thing that has been a real pebble in my shoe lately is(…)in terms of electronic devices and telephones in the hospital(…). In the bank, in the restaurant, ordering a coffee, going shopping, you’re not on your phone, speaking loudly on FaceTime, or watching a video and here in a crowded emergency in a stretcher next to a stretcher where I'm trying to take a history, people are doing face time, watching videos without headphones. And it’s very disruptive.” (ED)

Interdepartmental conflict
  • Ex 1. “You are fighting with your specialist colleagues, you’re having to nag people to do their job, get the tests done. Make sure that the procedures are completed in a timely manner.” (GIM)

  • Ex 2. “One area that I still fear, and hate is when you’re on call, and then you get pulled into a turf war. Right? You get the patient that bounces no one wants, and you're really getting pressure to admit, because in internal medicine, we have such a broad mandate” (GIM)

  • Ex 3. “I know the person that just checked in with an eye problem at 11pm, they might get seen at 10 in the morning… it is so discouraging to go into there.” (ED)

Heavy workload and scheduling
  • Ex 1. “I think weekends are some of the worst times for faculty… We typically are not assigned residents… you’re taking in reviews from two other teams from the night before managing your whole team… and then you’re often on call that night, then have to be back the next morning. So, I think weekends are a major source of burnout or stress for the attendings. Because we don’t have another person to help us yet we’re carrying actually more responsibility on weekends than we do during the rest of the week.” (GIM)

  • Ex 2. “There’s no such thing as a daycare that opens up at 7:00 (which) rules out a lot of dual physician family and or people with a kid in daycare and a partner… it makes life extremely more difficult. When really, we don’t need to be there at 7:30 for patient care.” (GIM)

  • Ex 3. “Definitely feeling pressed for time in a number of different ways…one because of the demand to move patients quickly” (ED)

Feeling undervalued
  • Ex 1. “Leadership, they don’t value what I bring to the table, I’m told to do whatever it is, my own leadership in my own department doesn’t stand up for me or doesn’t seem like they stand up for me because nothing ever changes… on top of that you have to care for and role model for residents and medical students… and I don’t think it’s valued or recognized by the organization.” (GIM)

  • Ex 2. “I do think our time isn’t always valued by some of the consultants.” (ED)

  • ED, emergency department; GIM, general internal medicine.