High-Stakes Medicine: Emergency Physician Stress and Its Ripple Effect on Patient Outcomes with Evidence-Based Coping Approaches

Mohamed Mukhtar¹, Thourya Mohamed², Musaab Mohammed³, Rayan Saeed⁴, Mohamed Hamza⁵

Abstract

Abstract

Background: Emergency medicine is recognized as one of the most burnout-prone specialties, posing risks to both physician well-being and patient care quality. This systematic review assesses the prevalence, causes, and consequences of emergency physician stress, as well as evidence-based coping strategies.

Methods: A total of 1,426 articles were screened across PubMed, Scopus, and ScienceDirect. After removing duplicates and applying eligibility criteria, 20 studies were included. These comprised 9 cohort studies, 5 cross-sectional surveys, 3 randomized controlled trials, 2 systematic reviews, and 1 expert consensus.

Results: Burnout prevalence among emergency physicians ranged from 45% to 70%, with pooled estimates reaching 65.2%. Emotional exhaustion was the most common symptom, particularly among physicians under 40 years and female physicians (63% burnout vs. 46% in males). High-impact risk factors included long shifts (n = 13 studies), lack of schedule control (n = 11), exposure to trauma or violence (n = 9), and administrative overload (n = 8). Eight studies reported direct consequences of burnout on patient outcomes. Physicians with burnout had 2.2 times greater odds of making safety-related errors and twice the odds of unprofessional behavior. Burnout also correlated with longer patient wait times, more diagnostic delays, and lower patient satisfaction.

Interventions: Eleven studies evaluated interventions. Digital mindfulness programs showed a 25% reduction in burnout scores after 6 weeks. Structured resilience training improved PTSD and emotional regulation outcomes. Organizational strategies, such as reduced consecutive night shifts, wellness curricula, and peer debriefings, led to improvements in teamwork and emotional exhaustion.

Conclusion: Burnout affects over two-thirds of emergency physicians and significantly compromises patient care. Effective interventions must be multilevel—targeting individual resilience and system-level reform. Addressing physician stress is essential to improving emergency department safety, efficiency, and workforce sustainability.