Elevating Physician Engagement: Meta-analysis of Influential Factors and Effective Strategies in Healthcare

Abstract: Physician burnout and turnover in the healthcare sector are indeed critical concerns that have gained significant attention worldwide in recent years. Burnout is a syndrome characterized by emotional exhaustion, cynicism, and a reduced sense of accomplishment among human service professionals (Maslach et al., 1997). Recent research, as part of the national burnout survey series, has highlighted how the Covid-19 pandemic has exacerbated these preexisting problems, leading to a rapid increase in the burnout rate among U.S. physicians. By the end of 2021, an alarming 63% of physicians reported experiencing burnout symptoms, a sharp increase from the 38% reported in the previous year (Shanafelt et al., 2022). While the serious impact of the pandemic may have receded from public view, the burnout experienced by healthcare professionals who have been on the front lines battling the virus remains a pressing and escalating issue. In responding to the issues of physician burnout, scholars have been adequately studied through either empirical studies or non-empirical studies such as systematic review and meta-analysis to identify the antecedents, consequences, and potential interventions (Doraiswamy et al., 2021; Macaron et al., 2023).
Simultaneously, researchers have focused on physician engagement (Scheepers et al., 2017; Simard et al., 2023; Underdahl et al., 2018), which is a positive opposite concept of burnout (Leiter & Maslach, 2005). The literature on engagement often used two closely related constructs: work engagement and employee engagement. Work engagement can be described as a favorable emotional and motivational condition characterized by elevated energy, high levels of dedication, and a strong work-oriented concentration (Schaufeli & Bakker, 2010). Employee engagement extends to include behavioral engagement with one’s organization and a proactive approach to work (Shuck et al., 2017). It is important to note that engagement, in its various forms, represents a desired goal for interventions aimed at mitigating burnout (Maslach & Leiter, 2008). However, current knowledge on the influential factors and effective strategies on physician engagement is dispersed. When it is most urgent to reduce physician’s burnout, comprehensively review the results of various studies and identifying and applying appropriate strategies and interventions are needed. Thus, this study aims to systematically synthesize and analyze data from multiple primary studies that examine factors influencing physician engagement and effective strategies and interventions for enhancing it. To achieve our research purpose, we have two research questions:
1. What are the primary factors that influence physician engagement?
2. What strategies and interventions have been effective in enhancing physician engagement?
In order to answer our research questions, we will conduct a meta-analysis. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to come up with final pools for meta-analysis. Meta-analysis combines data from multiple studies, enhancing the ability to determine significant effects, even when individual studies may lack sufficient power. In addition, it provides a comprehensive overview of the available evidence on a specific topic, allowing researchers and policymakers to make more informed decisions (Borenstein et al., 2021).
We conducted searches in databases including MEDLINE Ultimate, Academic Search Ultimate, and APA PsycInfo, using keywords such as engagement, physician*, and doctor*. Inclusion criteria required quantitative peer-reviewed articles with physician/doctor populations and full texts in English. In the initial search, 974 articles were identified, and after removing 461 duplicates, 513 articles remained for title and abstract screening. Following the screening process, 457 studies were found to be irrelevant. Consequently, 56 full-text studies were assessed for eligibility. Articles that did not focus on antecedents or interventions for physician engagement or did not report effect sizes were excluded. As a result, 26 studies were included in the analysis. At the time of this poster submission, the screening process was ongoing, and our goal was to complete this study before the conference to provide more robust results and discussions. While it is too early to provide the implications of this study, we expect several research and practical implications. First, we can provide a comprehensive overview of the most critical determinants that consistently influence physician engagement across multiple studies. Second, we can quantify the strength and direction of the relationships between antecedents, strategies, interventions and physician engagement. This knowledge empowers policymakers or healthcare administrators to develop tailored strategies (e.g., leadership training, workload management, improvements in work environments) and policies to enhance engagement among medical staff. Lastly, healthcare institutions can leverage the result to create healthier work environments that promote physician well-being, job satisfaction, and engagement and overall improvements in the quality of patient care.