Have studies exaggerated physician burnout's effect on quality of care?

A new study says the link between healthcare provider burnout and lower quality of patient care may be smaller than research suggests.

Researchers reviewed the published literature on burnout and a drop in quality of care and say studies may have exaggerated the effect.

“Burnout among healthcare providers is frequently associated with reduced quality of care in the published literature. However, few rigorous studies exist, and the effect size may be smaller than reported—and may be particularly smaller for objective quality measures,” said the authors of a study published in the Annals of Internal Medicine.

The researchers from Stanford University School of Medicine reviewed 123 previous studies that included 241,553 healthcare professionals. While many found an association between burnout and lower quality of care, that conclusion was based on varying study methods. Studies have linked burnout to failure to adhere to best practices, communication, medical errors, patient outcomes, and safety.

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The researchers said there is no standardized approach to measure and analyze the link between burnout and care quality, increasing the risk of bias of evidence.

However, the authors of an accompanying editorial concluded that despite the limitations of previous studies, it’s clear that higher burnout is associated with lower quality of care. “But we are left without clear answers about the magnitude or clinical significance of the relationship,” they wrote.

But the researchers and editorial authors both say that better methods are needed to measure the impact of burnout on quality of care.