Collaboration, EHR time are factors that can influence family physician burnout: study

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Burnout continues to be problematic for family physicians, but it helps when doctors have a good team and spend appropriate time using electronic health records (EHRs), according to a new study.

Meanwhile, value-based care (VBC) may be good for patient health, but also may add to the documentation burdens that contribute to burnout.

The findings were part of a new study in which researchers examined questions related to burnout on the American Board of Family Medicine’s Continuous Certification Questionnaire from 2017 to 2023. The study included 10,315 physicians who described their interactions with EHRs and the teams they worked with.

“These findings suggest that clinical leaders and policymakers should focus on optimizing primary care team support and family physicians’ EHR experiences to enhance the sustainability of primary care practice,” said the study.

The bad news: Burnout remains significant, with 37.9% of physicians reporting burnout in 2017. The self-reported numbers peaked in 2022, with 42.8% of doctors reporting feeling burned out on the job, and with no significant declines in any years of the study period.

As for team efficiency, perceptions decreased over time, from 65.8% in 2017 to 61.8% in 2023, although with a high at 68.4% in 2019. Appropriate time on EHRs at home increased from 53.1% of physicians reporting that outcome in 2017, to 62.5% in 2020 and landing at 58.5% in 2023.

The best ways to achieve both included collaborating with a registered nurse or physician assistant.

“Specific practice staffing features, such as collaborating with a registered nurse, were associated with greater odds of high team efficiency and appropriate home EHR time,” the study said. “These results underscore a need for clinical leaders to enhance the capacity and functioning of primary care teams while continuing efforts to minimize home EHR time. Both these goals appear to be potentiated by specific practice structure and staffing features.”

The study reported working in urban settings, and practicing in clinics with more than one clinician, created lower odds of attaining both team efficiency and appropriate time on EHRs. The finding about urban settings was surprising and warrants additional research, the study said.

Meanwhile, VBC did not help team efficiency or the joint outcome of team efficiency with appropriate home time in EHRs. That was consistent with earlier research that participating in VBC could increase burnout for doctors in small and medium-sized practices nationwide, the study said.

“Potential causes include a greater focus on and documentation burden from quality measurement and reporting in value-based payment models and a lack of consistent translation of value-based payment programs into the additional staffing needed to care for and document a range of patient needs,” the study said.

The authors noted the study did not objectively measure physician time spent and proficiency in EHRs, so the physicians’ perceptions may not align with their true time and training.

“Team and Electronic Health Record Features and Burnout Among Family Physicians” was published in JAMA Network Open.