The Effects of a Primary Care Transformation Initiative on Primary Care Physician Burnout and Workplace Experience
| Autor: | Nikkilyn Morrisson, Erin Fries Taylor, Sheila Hoag, John Holland, Kaylyn Swankoski, Laura L. Sessums, Timothy J. Day, Nancy Duda, Maya Palakal, Deborah Peikes, Jared Coopersmith |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Physician burnout macromolecular substances Primary care Burnout Affect (psychology) 01 natural sciences Job Satisfaction Physicians Primary Care 03 medical and health sciences Young Adult 0302 clinical medicine Surveys and Questionnaires Internal Medicine Medicine Humans 030212 general & internal medicine Prospective Studies 0101 mathematics Prospective cohort study Workplace Burnout Professional Primary Health Care business.industry Incidence 010102 general mathematics technology industry and agriculture Primary care physician Middle Aged United States Test (assessment) Cross-Sectional Studies Editorial Family medicine Job satisfaction Female business Delivery of Health Care Follow-Up Studies |
| Zdroj: | Journal of general internal medicine. 34(1) |
| ISSN: | 1525-1497 |
| Popis: | Physician burnout is associated with deleterious effects for physicians and their patients and might be exacerbated by practice transformation. Assess the effect of the Comprehensive Primary Care (CPC) initiative on primary care physician experience. Prospective cohort study conducted with about 500 CPC and 900 matched comparison practices. Mail surveys of primary care physicians, selected using cross-sectional stratified random selection 11 months into CPC, and a longitudinal design with sample replacement 44 months into CPC. Primary care physicians in study practices. A multipayer primary care transformation initiative (October 2012–December 2016) that required care delivery changes and provided enhanced payment, data feedback, and learning support. Burnout, control over work, job satisfaction, likelihood of leaving current practice within 2 years. More than 1000 physicians responded (over 630 of these in CPC practices) in each round (response rates 70–81%, depending on round and research group). Physician experience outcomes were similar for physicians in CPC and comparison practices. About one third of physician respondents in CPC and comparison practices reported high levels of burnout in each round (32 and 29% in 2013 [P = 0.59], and 34 and 36% in 2016 [P = 0.63]). Physicians in CPC and comparison practices reported some to moderate control over work, with an average score from 0.50 to 0.55 out of 1 in 2013 and 2016 (CPC-comparison differences of − 0.04 in 2013 [95% CI − 0.08–0.00, P = 0.07], and − 0.03 in 2016 [95% CI − 0.03–0.02, P = 0.19]). In 2016, roughly three quarters of CPC and comparison physicians were satisfied with their current job (77 and 74%, P = 0.77) and about 15% planned to leave their practice within 2 years (14 and 15%, P = 0.17). Despite requiring substantial practice transformation, CPC did not affect physician experience. Research should track effects of other transformation initiatives on physicians and test new ways to address burnout. ClinicalTrials.gov number, NCT02320591 |
| Databáze: | OpenAIRE |
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