Professional burnout and workforce attrition in emergency departments: an analysis from Tuscany, Italy

Emergency Departments (EDs) in Italy are facing a severe workforce crisis characterized by high attrition rates and difficulty in recruiting new physicians. This study aims to analyse the demographic characteristics, professional satisfaction, and underlying drivers of burnout among ED physicians in Italy, with a specific focus on the Tuscany region. We conducted a cross-sectional survey of 336 medical doctors working in Emergency Medicine. We have distributed an ad hoc questionnaire to investigate demographic profiles, employment status, specific sources of professional distress, and intentions to leave the field. The respondents were predominantly senior specialists (46% with >5 years of experience), while residents accounted for approximately 20% of the sample. The workforce is significantly aging, with 46 % of respondents over 60 years old. High levels of dissatisfaction were reported: the primary drivers of burnout were excessive workload (65 %), inadequate salary (61%), inappropriate ED visits (60%), and the phenomenon of boarding (55 %). Consequently, a significant proportion of physicians expressed an intention to leave the Emergency Department due to compromised work-life balance and structural inefficiencies. The study highlights a critical instability in the Italian Emergency Medicine workforce, driven by an aging population of specialists and systemic organizational failures rather than purely clinical stressors. Urgent interventions addressing salary, workload distribution, and hospital overcrowding (boarding) are essential to prevent further attrition and ensure the sustainability of the emergency healthcare system.