Harmful dimensions of medical culture across physician subgroups: a cross-sectional study of 1002 physicians predominantly practising in Belgium.

OBJECTIVES

To examine whether physicians’ endorsement of harmful dimensions of medical culture (HDMC)—namely Physicians’ Professional Commitment, the Myth of the Invulnerable Physician and Stigma towards Burnout—varies according to demographic and professional characteristics.

DESIGN

Cross-sectional online survey study.

SETTING

Primary and secondary care settings, predominantly in French-speaking Belgium, with additional recruitment in France.

PARTICIPANTS

1002 French-speaking physicians in clinical practice, including general practitioners, specialists, residents and attending physicians.

PRIMARY AND SECONDARY OUTCOME MEASURES: The outcomes examined were scores on the three dimensions of the revised 20-item HDMC model: Physicians’ Professional Commitment, the Myth of the Invulnerable Physician and Stigma towards Burnout. Analyses were exploratory. The specific subgroup comparisons and multivariable analyses reported in this study were not preregistered.

RESULTS

In multivariable analyses of 941 complete cases, higher Physicians’ Professional Commitment scores were associated with female gender (β=0.11), being a specialist rather than a general practitioner (β=0.15) and longer weekly working hours (β=0.29). Higher Myth of the Invulnerable Physician scores were associated with younger age (β=−0.32), female gender (β=0.20) and longer weekly working hours (β=0.08). Higher Stigma towards Burnout scores were associated with younger age (β=−0.13), being a specialist rather than a general practitioner (β=0.08) and longer weekly working hours (β=0.11). The models explained modest proportions of variance (adjusted R²=0.05–0.15).

CONCLUSIONS

Physicians’ endorsement of harmful dimensions of medical culture varied across demographic and professional characteristics, with distinct patterns across the three HDMC dimensions. Although associations were generally modest and subgroup differences should be interpreted cautiously, the findings highlight heterogeneity in how specific medical cultural norms are endorsed. Further research in independent and diverse samples is needed to examine how individual, professional, organisational and cultural contexts may shape these patterns.

STUDY PREREGISTRATION: The broader research project was preregistered on the Open Science Framework (OSF) https://doi.org/10.17605/OSF.IO/NTSZC