Practice Environments and Job Satisfaction in Patient-Centered Medical Homes

Alidina, Shehnaz; Rosenthal, Meredith B.; Schneider, Eric C.; Singer, Sara J.; Friedberg, Mark W.

doi:10.1370/afm.1662

Cited by 29 publications

(28 citation statements)

References 22 publications

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“…[45] Perceived workload is a more potent predictor of burnout than objective measures of workload, such as case load, because practitioners, like all human beings, are frequently motivated by perceptions rather than objective reality. [46] Strategies such as allowing a healthy degree of control (especially over schedules) plus implementing team-based [47,48] and collaborative care models [49] can reduce perceptions of heavy workload.…”

Section: Discussionmentioning

confidence: 99%

Predictors of burnout among physicians and advanced-practice clinicians in central New York

Waddimba

Nieves

Scribani

et al. 2015

JHA

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Background: Provider wellbeing is a barometer of the strength of healthcare systems/organizations. Burnout prevalence among physicians exceeds that among other adult workers in the United States. Rural-based practitioners might be at greater risk. Objective: We investigated predictors of burnout among group-employed providers within an integrated healthcare network. Methods: In a prospective observational study of physicians/advanced-practice clinicians serving an 8-county region of central New York, we linked administrative practice-setting data with responses to a questionnaire-survey comprising validated measures of burnout, resilience, work meaningfulness, satisfaction, risk aversion, and uncertainty/ambiguity tolerance. We included providers on the official payroll, excepting advisory board and/or research team members plus those who retired, resigned or were fired. 308 (65.1%) of 473 eligible clinicians completed the survey. 59.1% of these were physicians/doctoral-level practitioners; 40.9% advanced-practice clinicians. We assessed burnout using a validated 5-level single-item measure formatted as a binary outcome of "burned out/burning out" (levels 3-5) versus not. We derived a parsimonious generalized linear mixed-effects regression of this outcome on provider demographics, work-related needs, risk aversion, satisfaction, and unit characteristics. Results: Perceived workload, relatedness needs, practice satisfaction ≥ 75% of the time, dissatisfaction ≥ 50%, resilience, and practicing on a small unit were the significant, independent predictors. Conclusions: Heavy workloads, unmet relational needs, frequent dissatisfaction, low resilience, and serving on a small unit were most significantly associated with being "burned out/burning out". Feeling satisfied most of the time and high resilience were protective. Profession, specialty, autonomy, and support staffing were not statistically significant.

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Section: Discussionmentioning

confidence: 99%

Predictors of burnout among physicians and advanced-practice clinicians in central New York

Waddimba

Nieves

Scribani

et al. 2015

JHA

View full text Add to dashboard Cite

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“…Numerous studies have shown that changes in the work condition following health system reform can influence HCPs' job satisfaction and work experiences [17][18][19][20]. In fact, adopting new practice models requires changing existing practices and also organisational change which can create undue stress to HCPs [7].…”

Section: Abstract: Job Satisfaction Primary Care Interventions Heamentioning

confidence: 99%

“…To date, studies which address job satisfaction of HCPs in Malaysia remain scarce. The majority of studies evaluating job satisfaction following primary care transformation are mainly conducted in developed countries and often lack of a comparison group [18][19][20]27]. Therefore, the aim of this study is to evaluate the effects of EnPHC interventions implemented at facility level on HCPs' job satisfaction in the LMIC context.…”

Section: Abstract: Job Satisfaction Primary Care Interventions Heamentioning

confidence: 99%

The effects of enhanced primary healthcare interventions on primary care providers’ job satisfaction

Wong

Norzi

Ang

et al. 2020

BMC Health Serv Res

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Background: In response to the rising burden of cardiovascular risk factors, the Malaysian government has implemented Enhanced Primary Healthcare (EnPHC) interventions in July 2017 at public clinic level to improve management and clinical outcomes of type 2 diabetes and hypertensive patients. Healthcare providers (HCPs) play crucial roles in healthcare service delivery and health system reform can influence HCPs' job satisfaction. However, studies evaluating HCPs' job satisfaction following primary care transformation remain scarce in low-and middleincome countries. This study aims to evaluate the effects of EnPHC interventions on HCPs' job satisfaction. Methods: This is a quasi-experimental study conducted in 20 intervention and 20 matched control clinics. We surveyed all HCPs who were directly involved in patient management. A self-administered questionnaire which included six questions on job satisfaction were assessed on a scale of 1-4 at baseline (April and May 2017) and post-intervention phase (March and April 2019). Unadjusted intervention effect was calculated based on absolute differences in mean scores between intervention and control groups after implementation. Difference-in-differences analysis was used in the multivariable linear regression model and adjusted for providers and clinics characteristics to detect changes in job satisfaction following EnPHC interventions. A negative estimate indicates relative decrease in job satisfaction in the intervention group compared with control group.(Continued on next page)

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“…9 Yet few have reported how PCMH practice transformation affects satisfaction among community-based physicians. Of those few, researchers reported factors including strains on practice site resources and cultures, 10,11 practice “chaos,” 12 and the adequacy of reimbursements in light of PCMH transformation. 13 …”

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confidence: 99%

Physician Satisfaction in Practices That Transformed Into Patient-Centered Medical Homes

et al. 2015

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Patient-centered medical home (PCMH) transformation can significantly affect physicians' job satisfaction, which in turn can affect the quality of patient care. Between November 2012 and March 2013, the study team surveyed 159 community-based physicians in 159 practice sites that had experienced PCMH practice transformations in New York State. Of the 159 physicians, 121 responded (77% response rate) to the online survey. Nearly two thirds (60%) of physicians reported being somewhat or very satisfied overall with their practice after PCMH transformation. Overall satisfaction was lower than satisfaction with specific domains of practice: patient-centered care (82%), coordination of care (81%), access to care (79%), efficiency (76%), organizational culture (69%), and quality (69%). Although the physicians were moderately satisfied with care quality in their practices after PCMH transformation, their overall satisfaction was notably lower. The findings reveal a need to identify factors beyond quality for measuring physician satisfaction in PCMH transformed practices.

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Practice Environments and Job Satisfaction in Patient-Centered Medical Homes

Cited by 29 publications

References 22 publications

Predictors of burnout among physicians and advanced-practice clinicians in central New York

Predictors of burnout among physicians and advanced-practice clinicians in central New York

The effects of enhanced primary healthcare interventions on primary care providers’ job satisfaction

Physician Satisfaction in Practices That Transformed Into Patient-Centered Medical Homes

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