Objective:

To assess the prevalence, severity, and contributing factors of burnout among U.S. epilepsy physicians and identify protective workplace characteristics.

Background:

Physician burnout is a major public health issue with substantial implications for patient safety, quality of care, and healthcare costs. No studies specifically examined burnout within epilepsy subspecialty.

Design/Methods:

We conducted a survey of U.S. epilepsy physicians between October 2024 and February 2025. The 45-item instrument included the validated Mini-Z 2.0 scale to assess burnout severity, alongside questions on demographics, practice environment, and job satisfaction. Burnout and severe burnout were defined per Mini-Z criteria. Univariable and multivariable analyses were performed to identify associated factors.

Results:

Among 186 respondents, 176 complete responses were included in analysis. Burnout was reported by 96 (54.0%) and severe burnout by 35 (20.5%) participants; 136 of 154 (88%) agreed that burnout is a problem within the subspecialty. Physicians with burnout were more likely to indicate that they would not choose medicine (p<0.001) or epilepsy (p=0.002) again, and to plan leaving their current position or medicine altogether (p=0.016 for burnout; p=0.001 for severe burnout). In multivariable analysis, higher Mini-Z subscale 1 scores (p<0.001), adequate support staff (p=0.002), fellow coverage (p=0.010), and male gender (p=0.001) were protective against burnout. Each additional EMU admission per month increased the odds of burnout by 17% (p=0.056). Predictors of lower severe burnout included higher Mini-Z subscale 1 (p<0.001) and 2 (p=0.015) scores, presence of an advanced practice provider in clinic (p=0.022), practice outside the Midwest (p=0.012–0.034), and male gender (p=0.041).

Conclusions:

This is the first national study characterizing burnout among U.S. epilepsy physicians. Burnout is highly prevalent and associated with inadequate institutional support, chaotic work environments, and EMR frustration. Women and physicians in the Midwest appear at higher risk. These findings highlight the need for targeted organizational interventions to preserve clinician well-being and workforce sustainability.