Empowered doctors, staff foster low medical practice burnout, poll finds

By Ron Shinkman for Healthcare Dive

Dive Brief:

• A new study in Health Affairs found a correlation between lack of burnout and the overall cultural health and resiliency of medical practices.
• Researchers surveyed 715 medical practices in 12 states. Burnout was gauged by using the Maslach Burnout Inventory, a tool that measures emotional exhaustion of people on a five-point scale.
• The study concluded that burnout was highly correlated to how the practices were managed — strongly suggesting they functioned far better with a collaborative management style using proactive communications.

Dive Insight:

While burnout has long been a problem among medical professionals, a number of recent surveys suggest the pandemic exacerbated it.

More than 60% of frontline healthcare workers surveyed earlier this year by the Kaiser Family Foundation and the Washington Post said the pandemic has negatively impacted their mental health, and many have struggled getting the help they need.

And physicians’ trust in the U.S. healthcare system significantly declined during the pandemic, another recent survey from nonpartisan research group NORC at the University of Chicago, commissioned by the ABIM Foundation found.

Addressing and tackling drivers of burnout are key to enhancing an organization’s performance, Health Affairs researchers found in their study.

Burnout was fairly prevalent — less than a third of practices reported they experienced no burnout at all, while about 13% said they had high levels. High levels tended to be more commonplace in smaller practices of two to five clinicians (65% had high burnout); among clinician-owned practices (37.2%); or those owned by hospitals or health plans (37.2%); or were part of an accountable care organization (53.2%); or a patient-centered medical home (43.6%).

Solo practices or those with 11 or more clinicians tended to have lower levels of burnout than other practices. There was no correlation between burnout and patient volumes.

Those practices without burnout or low levels of burnout had significantly higher levels of resilience than those with high levels of burnout. They were much more likely to have “a strong practice culture — one in which teamwork, communication, psychological safety, mindfulness of others, facilitative leadership, and understanding that people make and can learn from mistakes,” according to the study.

Among the biggest predictors of low burnout was the use of participatory decisionmaking.

Those in lower burnout practices were also much more likely to believe they are working as part of a team, where there is a culture of learning, and the work environment is a “place of joy and hope.”

As a result, the study presented a blueprint of how to avoid burnout: empowering virtually everyone in the organization. “Larger practices and health systems can promote leadership and agency by delegating decision making to the lowest possible level of their organizations, and practices of all configurations could benefit from interprofessional leadership development,” the study concluded.