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Why doctors who work in small, independent primary care practices may have lower rates of physician burnout

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About half of all physicians experience burnout, according to multiple studies conducted of physicians who work in hospital settings, for large practices, and for themselves. However, when studies are conducted of independent physicians specifically, that burnout level tends to be significantly lower. A limited study of independent primary care physicians published recently in the Journal of the American Board of Family Medicine found that their burnout rate was only 13.5 percent.

An article published in AMA-Wire suggests a number of reasons for the lower burnout rate among independent primary care physicians:

Autonomy. Independent primary care physicians have more control over their administrative tasks, their work hours, and their overall working environment. This control helps reduce the amount of stress that may typically be found in a hospital or other healthcare facility, in which the primary care physician reports to a higher administrative level. The AMA article points out that previous studies have determined that “low work control and low autonomy has been linked with higher levels of burnout.”

Deeper relationships with patients. Along with that autonomy comes the ability to spend more time with patients, to communicate with them outside the office visit, and to get to know them better. Engaging with patients is the primary focus of most independent physicians’ work, so developing that deeper relationship with patients may lead to higher levels of job satisfaction and lower levels of burnout.

Fewer work hours. Independent primary care physicians establish their own office hours and have more control over their work schedule than those working for larger practices or for healthcare facilities. Exhaustion is a significant factor in burnout, so fewer work hours contribute to less stress and fatigue.

Higher adaptive reserve scores. The researchers who conducted the study of independent primary care physicians defined “adaptive reserve” as the independent physician practice’s “internal capacity for organizational learning and development.” The organizational capacity for change and for growth is much higher in an independent primary care practice and that can also lead to lower rates of physician burnout.