Physician practices that experience little to no workplace burnout have a number of things in common and could hold the key to combating the issue across the industry.
Historically, studies of workplace burnout among physician practices have focused on individual traits and occupational issues that contribute to the condition. A new cross-sectional study published in the latest edition of Health Affairs looks at the correlation between organization-level traits and the incidence of burnout.
Researchers hope that the factors identified in the study can form the basis for organizational best practices to reduce burnout more broadly.
“Practices without burnout had extraordinary practice cultures,” the study’s lead author, Samuel T. Edwards, assistant professor of medicine at Oregon Health and Science University, told Fierce Healthcare. “We looked at this adaptive reserve measure, which looked at domains of practice culture like facilitative leadership, sense-making, work environment, teamwork, cultural learning, relationship infrastructure, and those are all super strong."
RELATED: COVID-19 is exacerbating physician retention and burnout. Here are some tips to address it
The study found that zero-burnout organizations also differed structurally from higher-burnout practices. Solo and small practices that were clinician-owned and not participating in accountable care organizations or other large-scale quality demonstration projects saw less burnout than their peers.
While such a study can’t definitively identify best practices for organizations, Edwards believes this research helps give a clear picture of things that matter. “Agency at the practice level is important—people having a sense of control over how their job works and how their practice works is important, and I think we see that here,” he says.
In larger organizations, he advises trying to push agency as far down the hierarchy as possible. “Allowing individual work units to design their own workflow and have less central control seems like it would be a conclusion from this work,” Edwards said. Promoting a leadership culture dedicated to more collaborative and less-hierarchical working conditions is another potential area for larger organizations to explore as they work on reducing burnout in their ranks, he said.
Further underscoring this conclusion, the research found no correlation between the volume of patients physicians saw and the incidence of burnout. “In a smaller practice with strong relationships and a strong sense of mission, control over practice schedules, they’re choosing to work hard because they care about the work and patients, so they’re not burned out,” Edwards said.
RELATED: Wave of consolidation may be coming as independent physicians report COVID-19 concerns: McKinsey
The connection between agency and lower burnout levels also suggests increased burnout could be a potential side effect of ongoing industry consolidation. As a result, finding ways to support smaller primary care practices at a policy level could also play into an overarching industry push to reduce burnout among physicians.
The most promising aspect of the research may be the substantial number of organizations that have managed to find approaches that work when it comes to curbing burnout. “Burnout has been a simmering crisis for a while, yet in our sample, 30% of practices reported that they had no burnout at all—and not just among their physicians, but throughout the practice,” Edwards said.
As the industry begins to identify and implement best practices, there appears to be reason to hope more organizations can follow suit.