• Janis M Miyasaki, Carol Rheaume, Lisa Gulya, Aviva Ellenstein, Heidi B Schwarz, Thomas R Vidic, Tait D Shanafelt, Terrence L Cascino, Chris M Keran, and Neil A Busis.
• From the Department of Medicine, Division of Neurology (J.M.M.), University of Alberta, Edmonton, Canada; Member Insights Department (C.R., L.G., C.M.K.), American Academy of Neurology, Minneapolis, MN; Department of Neurology (A.E.), George Washington University, Washington, DC; Department of Neurology (H.B.S.), University of Rochester Medical Center, NY; Department of Neurology (T.R.V.), Elkhart Clinic, IN; Departments of Medicine, Hematology and Oncology (T.D.S.) and Neurology (T.L.C.), Mayo Clinic, Rochester, NY; and Department of Neurology (N.A.B.), University of Pittsburgh School of Medicine, PA. Miyasaki@ualberta.ca.
• Neurology. 2017 Oct 17; 89 (16): 1730-1738.

ObjectiveTo understand the experience and identify drivers and mitigating factors of burnout and well-being among US neurologists.MethodsInductive data analysis was applied to free text comments (n = 676) from the 2016 American Academy of Neurology survey of burnout, career satisfaction, and well-being.ResultsRespondents providing comments were significantly more likely to be older, owners/partners of their practice, solo practitioners, and compensated by production than those not commenting. The 4 identified themes were (1) policies and people affecting neurologists (government and insurance mandates, remuneration, recertification, leadership); (2) workload and work-life balance (workload, electronic health record [EHR], work-life balance); (3) engagement, professionalism, work domains specific to neurology; and (4) solutions (systemic and individual), advocacy, other. Neurologists mentioned workload > professional identity > time spent on insurance and government mandates when describing burnout. Neurologists' patient and clerical workload increased work hours or work brought home, resulting in poor work-life balance. EHR and expectations of high patient volumes by administrators impeded quality of patient care. As a result, many neurologists reduced work hours and call provision and considered early retirement.ConclusionsOur results further characterize burnout among US neurologists through respondents' own voices. They clarify the meaning respondents attributed to ambiguous survey questions and highlight the barriers neurologists must overcome to practice their chosen specialty, including multiple regulatory hassles and increased work hours. Erosion of professionalism by external factors was a common issue. Our findings can provide strategic direction for advocacy and programs to prevent and mitigate neurologist burnout and promote well-being and engagement.© 2017 American Academy of Neurology.

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