The Relationship Between Primary Care Physician Burnout and Patient-Reported Care Experiences: a Cross-sectional Study

Background Primary care physician (PCP) burnout is prevalent and on the rise. Physician burnout may negatively affect patient experience of care. Objective To identify the direct impact of PCP burnout on patient experience in various domains of care. Design A cross-sectional observational study using physician well-being (PWB) surveys collected in 2016-2017, linked to responses from patient experience of care surveys. Patient demographics and practice characteristics were derived from the electronic health record. Linked data were analyzed at the physician level. Setting A large non-profit multi-specialty ambulatory healthcare organization in northern California. Participants A total of 244 physicians practicing internal medicine or family medicine who responded to the PWB survey (response rate 72%), and 30,701 completed experience surveys from patients seeing these physicians. Measurements Burnout was measured with a validated single-item question with a 5-point scale ranging from (1) enjoy work to (5) completely burned out and seeking help. Patient experience of patient-provider communication, access, and overall rating of provider was measured with Clinician & Group Consumer Assessment of Healthcare Providers & Systems (CG-CAHPS) survey. Patient experience scores (0-100 scale) were adjusted for age, gender, race/ethnicity, and English proficiency. Results Physician burnout had a negative impact on patient-reported experience of patient-provider communication but not on access or overall rating of providers. A one-level increase in burnout was associated with 0.43 decrease in adjusted patient-provider communication experience score (P < 0.01). Limitations Data came from a single large healthcare organization. Patterns may differ for small- and mid-sized practices. Conclusion Physician burnout adversely affects patient-provider communication in primary care visits. Efforts to improve physician work environments could have a meaningful positive impact on patient experience as well as physician well-being.