Generative AI Use, Perceived Usefulness, Perceived Risk, and Physician Burnout and Fulfillment Among Chinese Physicians: Mixed Methods Multiregional Study

BACKGROUND: As generative AI (GenAI) becomes increasingly prevalent, its impact on physician mental health has garnered significant attention; yet, empirical evidence remains limited. OBJECTIVE: This study aims to investigate the correlations between the usage frequency of GenAI, perceived usefulness (PU), and perceived risk (PR) of GenAI with physicians' burnout and professional fulfillment. METHODS: A mixed methods design was used, integrating a quantitative survey of physicians across 4 regions in China with in-depth qualitative interviews to elucidate the underlying psychological mechanisms. The quantitative component involved a cross-sectional survey of 961 physicians, with the questionnaire collecting data on demographic and professional characteristics, socioeconomic status, GenAI usage frequency, PU, and PR. Semistructured interviews with 10 physicians were used for in-depth mining. Multivariable logistic and linear regression models with province-level fixed effects were fitted to examine the association between usage of GenAI, PU, PR, and physicians' burnout and fulfillment. Stratified analyses were further performed to explore the moderating effect of demographic and clinical characteristics. RESULTS: Quantitative analysis revealed no direct correlation between GenAI usage frequency and burnout. However, PU was positively associated with professional fulfillment (odds ratio [OR] 1.56, 95% CI 1.17-2.08; P=.003), whereas PR was associated with a higher likelihood of burnout (OR 1.80, 95% CI 1.46-2.21; P<.001). Stratified analyses showed that for physicians working ≥3 night shifts per week, GenAI usage was associated with higher odds of burnout, although the estimate was imprecise (OR 13.96, 95% CI 2.40-81.04; P=.003). The qualitative findings further suggested that the benefits of using GenAI may be offset by the additional burden. The PU of GenAI was perceived to enhance professional fulfillment by bolstering self-efficacy, whereas the PR of GenAI was linked to heightened burnout rooted in unclear boundaries of responsibilities and rights, as well as challenges to professional identity. CONCLUSIONS: The GenAI revolution in medicine is as much a psychological transition as it is a technological one. GenAI use is not directly associated with improved psychological states among clinicians. The PU of GenAI relates to professional fulfillment, and the PR concerns correspond to elevated burnout. Sustaining clinician well-being during this digital shift thus parallels a dual requirement, balancing the potential for professional fulfillment tied to GenAI utility against the concurrent verification fatigue and legal uncertainty cluster around clinician burnout.