More workplace control leads to less burnout for physicians in health systems, study finds

© M Bam /peopleimages.com - stock.adobe.com

More workplace control could be a solution to reduce physician burnout and the intention to reduce clinical work or leave a job, according to a new study.

“Physician control and influence over their immediate care environment has declined over the last several decades,” and increasing control and influence could have positive effects for doctors, according to the study, “Association of Work Control With Burnout and Career Intentions Among U.S. Physicians: A Multi-Institution Study,” published in Annals of Internal Medicine.

The research involved 2,339 physicians across 19 organizations from November 2022 to December 2023. They were asked questions about workplace conditions, such as control over the volume of patient load, clinical team membership, hiring staff, setting clinical schedules and workload. Physicians also answered questions about their intentions to reduce time devoted to clinical care, and their levels of workplace burnout.

The results: Lower levels of control were associated with higher levels of burnout, intent to reduce clinical time, and intent to leave the job, the study said.

The researchers said it was the first large, contemporary study to analyze specific dimensions of work control with burnout and career plans. They said it was notable that the results are part of a health care landscape in which physicians are less likely to own their own practices.

“Although large health care systems may seek to standardize operations, templates, and resource availability, our results suggest the value of balancing such standardization with approaches that enhance physician influence and control over operational decisions,” the study said.

Some examples:

• Granting physicians greater influence over clinical scheduling, such as start and stop times for clinic sessions and appointment duration, or shift choices.
• Granting doctors authority over composition of clinical teams, such as the number of clinical assistants, their training levels, and using stable pairings vs. pools of interchangeable team members.
• Giving physicians a voice in delegating tasks to a care team.

The researchers said another recent study found health care executives agreed a top priority is to recruit and retain the physician workforce. Granting control of some aspects of practice may be at odds with organizational initiatives to standardize conditions such as scheduling and workflow, but it is imperative to find the right balance between standardization and flexibility, they said.

By the numbers

The study included survey results with the percentages of physicians who felt they had adequate control over various work conditions. The work conditions and percentages with adequate control were:

• Volume of patient load – 61.4%
• Members of the clinical team – 60.6%
• Hiring of staff – 49%
• Setting clinical schedules – 74.6%
• Domains for which physicians are accountable – 58.3%
• Workload – 61.3%

Of those six, poor control over patient load, team members, clinical schedule, accountable domains and workload all contributed to burnout. Poor control over patient load and workload contributed to intent to reduce clinical time, while poor influence over hiring, accountable domains and workload all were associated with intent to leave, the study said.

Among the respondents, family medicine had the most at 350, and there were 167 general internal medicine – primary care physicians. Some of the other top specialties were 330 pediatricians, 220 emergency medicine doctors, and 109 obstetrician-gynecologists, according to the results.