Organizational Interventions Needed to Prevent Burnout Among Family Physicians
Physicians, including primary care physicians, experience a higher rate of burnout than those in many other professions. In a special issue of the Journal of the American Board of Family Medicine, entitled Well-Being of the Health Care Team, several studies by researchers at ABFM report on factors affecting burnout in family physicians. Their research demonstrates that both individual and organizational level interventions are needed to prevent burnout in family physicians, and that team efficiency with adequate clinical support is a necessary and effective intervention.
In the article Gender Differences in Personal and Organizational Mechanisms to Address Burnout among Family Physicians, researchers found that 55% of female family physicians reported burnout compared to 50% of males. Both female and male family physicians take a variety of steps to reduce burnout, most commonly starting or maintaining a regular exercise or mindfulness regimen. Female family physicians are also more likely than males to work reduced hours, employ domestic help at home, and seek therapy to help reduce burnout, while males are more likely to spend more times on hobbies. While 20% of all family physicians reported that their organization offered a formal wellness program, an equal number said their organization did not offer any type of well-being support. A second study, entitled Burnout Among Family Physicians by Gender and Age, supported the finding that overall female family physicians are more likely than males to report burnout. However, for physicians 60 years or older, the gender gap was almost non-existent. As more women are entering the family physician workforce than men, policy makers and health system administrators may need to consider varied approaches to address burnout prevention and management in order to ensure a healthy primary care workforce.
With respect to organizational factors, the article on Team Configurations, Teamwork Efficiency and Family Physician Burnout found a strong association between perceived teamwork efficiency and burnout. Family physicians who work with a more expansive team, including a medical assistant or nurse, and/or a nurse practitioner or physician assistant, and/or allied health professionals (e.g., pharmacist, psychiatrist or social worker) tended to view their practice environment more favorably, especially compared to those working with only a medical assistant or nurse. Still, 41% of family physicians reported feeling burned out once a week or more, which was consistent even among different team configurations. Lowest rates of burnout were reported in academic and hospital owned practices. Solo practices also reporting lower burnout than those in larger practices. In practices where physicians perceived greater control of their workload and/or had value alignment with practice leaders they were much less likely to report burnout. Authors emphasize that improving teamwork efficiency could prove effective for supporting physician well-being as well as team functioning.
“For the organizational or system-level factors that contribute to burnout as reported in this issue and in earlier studies, individually-focused interventions and coping mechanisms alone cannot adequately address physician burnout; indeed, placing the onus on individual physicians to deal with the consequences of burnout might have the unintended consequence of increasing feelings of burnout,” said lead author Aimee Eden, PhD, MPH, Medical Anthropologist at the American Board of Family Medicine.
The full articles can be found in a special issue of the Journal of the American Board of Family Medicine, entitled Well-Being of the Health Care Team.