Physician Burnout and the Patient Relationships
Node Smith, ND
Physician Burnout and Meeting Patient’s Social Needs
Twenty-nine primary care clinicians provided insight into the relationship between patient social needs and physician burnout through semi-structured interviews.
Four key themes appeared throughout these interviews: (1) burnout can affect how clinicians evaluate their clinic’s social needs resources; (2) unmet social needs affect practices by influencing clinic flow, treatment planning, and clinician emotional wellness; (3) social services embedded in primary care clinics buffer against burnout by increasing efficiency, restoring clinicians’ medical roles, and improving morale; and (4) clinicians view clinic-level interventions to address patients’ social needs as a necessary but insufficient strategy to address burnout.
The clinicians noted the importance of social needs interventions being timely, accessible and tailored to each individual patient, while being responsive to patient feedback. The clinicians were skeptical that referral-based interventions based solely on referrals would adequately address patients’ social needs.
Burnout and Practice Environment
With the rate of burnout as high as 63% among family physicians, it is important to identify risk factors for physician burnout. The relationship between burnout and personal environmental and organizational risk factors was examined in a study of family physicians.
A cross-sectional study of 1,437 physicians seeking to continue their American Board of Family Medicine Certification in 2017 was created using data from the examination registration process. Burnout was measured as a positive response to either of two validated questions measuring emotional exhaustion and depersonalization. The study revealed a burnout rate of 43.7%, of which 33.7% worked in hospital-owned practices and 65.5% had no ownership stake in their practice. Controlling for personal characteristics and practice organization, being in a hospital-owned practice and being a partial owner were positively associated with burnout. When also controlling for practice environment, no practice organization variable remained associated with burnout.
The most important predictors of burnout
The most important predictors of burnout were practice environment factors such as satisfaction with hours worked, control over workload, value alignment with department leaders, and sufficient time for documentation.
1st study: Kung, A., et al. (2019) Capacity to Address Social Needs Affects Primary Care Clinician Burnout. Annals of Family Medicine. doi.org/10.1370/afm.2470.
2nd study: Creager, J., et al. (2019) Associations Between Burnout and Practice Organization in Family Physicians. Annals of Family Medicine. doi.org/10.1370/afm.2448.
Node Smith, ND, is a naturopathic physician in Humboldt, Saskatchewan and associate editor and continuing education director for NDNR. His mission is serving relationships that support the process of transformation, and that ultimately lead to healthier people, businesses and communities. His primary therapeutic tools include counselling, homeopathy, diet and the use of cold water combined with exercise. Node considers health to be a reflection of the relationships a person or a business has with themselves, with God and with those around them. In order to cure disease and to heal, these relationships must be specifically considered. Node has worked intimately with many groups and organizations within the naturopathic profession, and helped found the non-profit, Association for Naturopathic Revitalization (ANR), which works to promote and facilitate experiential education in vitalism.