Burnout and Scope of Practice in New Family Physicians

Weidner, Amanda; Phillips, Robert L.; Fang, Bo; Peterson, Lars E.

doi:10.1370/afm.2221

Cited by 75 publications

(105 citation statements)

References 40 publications

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“…9 Yet, recent evidence, including findings from this study, suggest that number of hours worked by itself may not be directly related to burnout. 36 Factors such as perceived control over work, autonomy, relatedness, competence, and values congruence may be important factors influencing burnout in large and small practices. 37 Social determination theory (SDT) suggests that three innate psychological needs drive human well-being: autonomy, relatedness, and competence, and-when fulfilled-people express vitality, curiosity, and self-motivation.…”

Section: Discussionmentioning

confidence: 99%

Burnout Among Physicians, Advanced Practice Clinicians and Staff in Smaller Primary Care Practices

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Burnout Among Physicians, Advanced Practice Clinicians and Staff in Smaller Primary Care Practices

et al. 2018

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“…Burnout was defined as the presence of either of these once a week or more. 1,19 Although originally defined as having 3 components: emotional exhaustion, depersonalization, and a reduced sense of personal achievement, 20 there is evidence that a reduced sense of personal accomplishment develops independently and tends to correlate more weakly with most important causes and effects of burnout. 21,22 For these reasons, it is reasonable to use only the first 2 of 3 original domains to assess burnout.…”

Section: Methodsmentioning

confidence: 99%

Associations Between Burnout and Practice Organization in Family Physicians

2019

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PURPOSE Burnout has been reported to be as high as 63% among family physicians and has negative effects on physicians, patients, and the medical system. There are likely structural causes of burnout, but little is known about the relationship between practice organization and burnout. Our objective was to study this association in family physicians. METHODS This cross-sectional study uses secondary data supplied by practicing physicians from the 2017 American Board of Family Medicine (ABFM) Family Medicine Certification examination registration questionnaire, a mandatory component of registration, yielding a 100% response rate. Burnout was measured as a positive response to either of 2 validated questions measuring emotional exhaustion and depersonalization. Practice environment was measured with questions on work stressors and teamwork. Logistic regression determined independent associations between burnout and individual and practice characteristics. RESULTS Of the 1,437 physicians included, the burnout rate was 43.7%; 33.7% worked in hospital-owned practices and 65.5% reported no ownership stake in their practice. Controlling for personal characteristics and practice organization, being in a hospital-owned practice (odds ratio (OR) = 1.68; 95% CI, 1.14-2.46) and being a partial owner (OR =1.67; 95% CI, 1.13-2.46) were positively associated with burnout. When also controlling for practice environment, no practice organization variable remained associated with burnout. CONCLUSION Burnout in family physicians should not be attributed solely to practice organization. No single practice type or ownership status was independently associated with burnout, which indicates that any practice can attempt to mitigate burnout.

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“…The National Academy of Medicine outlines potential organizational, practice, financial, and regulatory environment considerations to identify increased risk of burnout. 80 Recently, a collaborative report of distinguished Massachusetts institutions issued a call to action to fight physician burnout. 81 It was recommended that every major health care organization appoint an executive-level chief wellness officer to champion burnout reduction and its etiology.…”

Section: Future Directionsmentioning

confidence: 99%

Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systematic Review

DeChant

Acs

Rhee

et al. 2019

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

119

132

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To assess the impact of organization-directed workplace interventions on physician burnout, including stress or job satisfaction in all settings, we conducted a systematic review of the literature published from multiple databases. Manual searches of grey literature and bibliographies were also performed. Of the 633 identified citations, 50 met inclusion criteria. Four unique categories of organization-directed workplace interventions were identified. Teamwork involved initiatives to incorporate scribes or medical assistants into electronic health record (EHR) processes, expand team responsibilities, and improve communication among physicians. Time studies evaluated the impact of schedule adjustments, duty hour restrictions, and time-banking initiatives. Transitions referred to workflow changes such as process improvement initiatives or policy changes within the organization. Technology related to the implementation or improvement of EHRs. Of the 50 included studies, 35 (70.0%) reported interventions that successfully improved the 3 measures of physician burnout, job satisfaction, and/or stress. The largest benefits resulted from interventions that improved processes, promoted teambased care, and incorporated the use of scribes/medical assistants to complete EHR documentation and tasks. Implementation of EHR interventions to improve clinical workflows worsened burnout, but EHR improvements had positive effects. Time interventions had mixed effects on burnout. The results of our study suggest that organization-directed workplace interventions that improve processes, optimize EHRs, reduce clerical burden by the use of scribes, and implement team-based care can lessen physician burnout. Benefits of process changes can enhance physician resiliency, augment care provided by the team, and optimize the coordination and communication of patient care and health information.

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Burnout and Scope of Practice in New Family Physicians

Cited by 75 publications

References 40 publications

Burnout Among Physicians, Advanced Practice Clinicians and Staff in Smaller Primary Care Practices

Burnout Among Physicians, Advanced Practice Clinicians and Staff in Smaller Primary Care Practices

Associations Between Burnout and Practice Organization in Family Physicians

Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systematic Review

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