The Relationship Between Primary Care Physician Burnout and Patient-Reported Care Experiences: a Cross-sectional Study

Abstract

BACKGROUND: Primary care physician (PCP) burnout is prevalent and on the rise. Physician burnout may negatively affect patient experience of care. OBJECTIVE: To identify the direct impact of PCP burnout on patient experience in various domains of care. DESIGN: A cross-sectional observational study using physician well-being (PWB) surveys collected in 2016-2017, linked to responses from patient experience of care surveys. Patient demographics and practice characteristics were derived from the electronic health record. Linked data were analyzed at the physician level. SETTING: A large non-profit multi-specialty ambulatory healthcare organization in northern California. PARTICIPANTS: A total of 244 physicians practicing internal medicine or family medicine who responded to the PWB survey (response rate 72%), and 30,701 completed experience surveys from patients seeing these physicians. MEASUREMENTS: Burnout was measured with a validated single-item question with a 5-point scale ranging from (1) enjoy work to (5) completely burned out and seeking help. Patient experience of patient-provider communication, access, and overall rating of provider was measured with Clinician & Group Consumer Assessment of Healthcare Providers & Systems (CG-CAHPS) survey. Patient experience scores (0-100 scale) were adjusted for age, gender, race/ethnicity, and English proficiency. RESULTS: Physician burnout had a negative impact on patient-reported experience of patient-provider communication but not on access or overall rating of providers. A one-level increase in burnout was associated with 0.43 decrease in adjusted patient-provider communication experience score (P < 0.01). LIMITATIONS: Data came from a single large healthcare organization. Patterns may differ for small-and mid-sized practices. CONCLUSION: Physician burnout adversely affects patient-provider communication in primary care visits. Efforts to improve physician work environments could have a meaningful positive impact on patient experience as well as physician well-being.

Prevalence and impact of burnout, secondary traumatic stress and compassion satisfaction on hand hygiene of healthcare workers in medical aid team during COVID-19 pandemic

“…The experience of zero infection in medical aid team also proves the effective management in medical aid team, in the aspect of protective equipment. In addition, we can observe that the environment of management and public may be highly associated with the burnout and compassion satisfaction of HCWs [25,26].…”

Prevalence and severity of burnout in Hong Kong doctors up to 20 years post-graduation: a cross-sectional study

“…At an institutional level, burnout affects the quality of healthcare. Studies show that doctors with burnout make more mistakes, 5 have reduced professional work effort, 6 have poorer patient–doctor communication 7 and self-report suboptimal care to patients. 4 Burnout has also been associated with increased days of work absenteeism, 8 increased intention to leave their work, 9 earlier retirement and reduced clinic hours.…”

Primary Care Clinician Burnout and Engagement Association With Clinical Quality and Patient Experience

“…For example, a recent study using a single-item measure of self-reported burnout found a negative association between primary care physician burnout and patient ratings of physician communication, but no association between burnout and overall patient rating of the physician. 36 Our finding suggests that there is a phenotype of very committed, hard-working, and exhausted clinicians who are perceived by patients to be excellent, patient-centered clinicians, despite the toll that this disposition may take on the clinician's wellbeing. The co-occurrence of high burnout and high engagement may be a characteristic of missiondriven individuals who prioritize the importance or impact of their work over considerations of worklife balance.…”

“…Response rates to the CG-CAHPS were 12% to 13%, which is consistent with rates reported by other organizations for routinely administered patient experience surveys. [35][36][37] CG-CAHPS measures for the clinicians in the study sample were derived from 9000 completed patient experience surveys, with a mean of 51 and a range of 5 to 325 patient responses per clinician. Consistent with CG-CAHPS reporting, the score at the clinician level for each item was computed as the percentage of survey respondents giving the clinician the highest possible rating for the measure.…”