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July 9, 2018
According to one study, physicians working in small independent primary care practices – also known as SIPs – report significantly lower levels of burnout than the national average ( 13.5% vs. 54.4%) Led by NYU researchers School of Medicine Online July 9th in the Journal of the American Board of Family Medicine . The results indicate that the independence and sense of autonomy that providers have in these small practices can provide some protection against the symptoms of burnout.
The burnout of doctors is a major concern for the health care industry. It is badociated with low job satisfaction, reduced physician productivity, and can negatively affect the quality of care. Multiple national surveys suggest that more than half of doctors report symptoms of burnout.
The research on the burnout of physicians is mainly focused on hospital settings or major primary care practices. Researchers say it's the first study that examines the prevalence of physician burnout in small independent primary practices – practices with five or fewer physicians. Despite the decrease in the number of small firms in the United States, mainly because of market forces that promote consolidation, nearly 70% of all visits to primary care offices are in small practices, according to the report. American Medical Association.
collected from 235 physicians practicing in 174 SIPs in New York. The rate of burnout reported by claimants was 13.5%, compared to the national rate of 54.4% in 2014. A meta-badysis of surveys conducted in the United States and Europe in 2013 found that burnout rates were badociated with greater perceived autonomy, a culture of quality and safety at work, and skills that were important. Effective adaptation and to a conflict between work and personal life. Depletion affects the culture and infrastructure of practice in which primary care physicians work, which poses the obvious question: what is happening in the workplace that leads to low burnout rates in small businesses? said Donna Shelley, MD, professor of population health and medicine at the School of Medicine at the University of New York, and the lead author of the study. "It is important to study the group that does not show high burnout to help us create environments that promote lower burnout rates.The good news is that a culture and systems can be modified to support primary care physicians in a way that reduces factors
How the study was conducted
The researchers badyzed the data as part of the HealthyHearts NYC (HHNYC) trial, which is funded by the National Agency for Health Research and Quality (AHRQ) EvidenceNOW Initiative. AHRQ is a division of the US Department of Health and Human Services. The HHNYC trial badesses how coaching or facilitation of practice helps ISPs to adopt clinical guidelines for the treatment and prevention of cardiovascular disease.
Each doctor answered a multiple choice question with response options indicating different levels of burnout. The options ranged from the absence of symptoms of burnout to a feeling of complete exhaustion and the question of whether to continue practicing medicine. The issue has been validated against the Maslach Burnout Inventory, a nationally recognized measure that identifies burnout. The responding physicians were categorized as exhausted when they checked one of the last three options of the multiple choice question.
As part of the HHNYC trial, the physicians surveyed were also asked to answer a number of questions about the culture of their practices. The tool used specifically measures the "adaptive reserve", or a culture where individuals have opportunities for growth, and the ability to learn from mistakes by talking and listening to each one. Doctors who have described this type of culture in their practice have reported lower levels of burnout. According to Dr. Shelley, practices where employees feel included in decisions and control their workplace are referred to as "high adaptive reserve".
Dr. Shelley is careful not to minimize the difficulties that doctors face. She says that while burnout rates are lower, many of these practices are financially challenged, and many of these physicians are listening all the time
"The more we understand what lowers the rate of burnout. "Mr. Shelley said, "We hope our research will find ways for large systems to promote self-reliance in practices so that there is space to sculpt.
Dr. Shelley lists a number of limitations of the study, since the results are representative of physicians who work in small clinics in New York. City, the study does not take into account burnout rates in other cities in the country. It is also possible that researchers have underestimated the number of hours worked by doctors, since hours worked are badociated with burnout. Shelley also cited the lack of data linking the depletion of doctors to the results for patients.
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