Physician Burnout and Patient Satisfaction with Consultation in Primary Health Care Settings: Evidence of Relationships from a one-with-many Design
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Physician burnout, as a prolonged response to chronic emotional and interpersonal stressors on the job, has been associated with suboptimal patient care and deterioration in the patient–provider relationship. Although prior studies have identified a range of factors associated with decreased patient satisfaction, most have been conducted in tertiary care settings, with staff burnout examined at the hospital unit-level. To examine the impact of physician burnout on patient satisfaction from consultation in the primary care setting, a cross-sectional survey was conducted in Western Greece. Using a one-with-many design, 30 physicians and 300 of their patients, randomly selected, responded to the survey. Results showed that patient satisfaction correlated significantly with physician emotional exhaustion (r = −.636, p < .01) and physician depersonalization (r = −.541, p < .01). Mixed-effects multilevel models indicated that 34.4% of total variation in patients’ satisfaction occurred at the physician level, after adjustment for patients’ characteristics. Moreover, physician emotional exhaustion and depersonalization remained significant factors associated with patient satisfaction with consultation, after controlling for patient and physician characteristics. Patients of physicians with high-exhaustion and high-depersonalization had significantly lower satisfaction scores, compared with patients of physicians with low-exhaustion and low-depersonalization, respectively. Future studies need to explore the mechanisms by which physician burnout affects patient satisfaction.
KeywordsPrimary care Physician burnout Patient satisfaction Mixed-effects Multilevel analysis
The authors gratefully acknowledge the helpful advice and support offered by Professor Debra Roter.
- Anagnostopoulos, F., & Papadatou, D. (1992). Factorial composition and internal consistency of the Greek version of the Maslach Burnout Inventory administered to a sample of nurses. Psychological Themata, 5, 183–202.Google Scholar
- Hobfoll, S. E., & Freedy, J. (1993). Conservation of resources: A general stress theory applied to burnout. In W. B. Schaufeli, C. Maslach, & T. Marek (Eds.), Professional burnout: Recent developments in theory and research (pp. 115–129). Washington, DC: Taylor & Francis.Google Scholar
- SPSS, Inc. (2005). Linear mixed-effects modelling in SPSS: An introduction to the MIXED procedure. Retrieved July 10, 2009, from http://www.spss.com/downloads/papers.cfm
- Maslach, C., & Jackson, S. E. (1986). Maslach Burnout Inventory (Manual) (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.Google Scholar
- Raudenbush, S., Bryk, A., Cheong, Y. K., Congdon, R., & du Toit, M. (2004). HLM (Version 6) [Computer Software]. Lincolnwood, IL: Scientific Software International, Inc.Google Scholar
- Roter, D. (2006). The patient-physician relationship and its implications for malpractice litigation. Journal of Health Care Law and Policy, 9, 304–314.Google Scholar
- Saarinen, F. (2004). Using mixed models in a cross-over study with repeated measurements within periods. Retrieved June 15, 2009, from http://www.math.su.se/matstat.
- Salisbury, C., Wallace, M., & Montgomery, A. A. (2010). Patients’ experience and satisfaction in primary care: Secondary analysis using multilevel modelling. British Medical Journal, 341(oct 12 1), c5004. doi: 10.1136/bmj.c5004.
- Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D. (2004). Nurse burnout and patient satisfaction. Medical Care, 42, II-57–II-66.Google Scholar
- Williams, E. S., Baier-Manwell, L., Konrad, T. R., & Linzer, M. (2007). The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: Results from the MEMO study. Health Care Management Review, 32, 203–212.PubMedCrossRefGoogle Scholar
- Williams, E. S., Lawrence, E. R., Sydow-Campbell, K., & Spiehler, S. (2009). The effect of emotional exhaustion and depersonalization on physician-patient communication: A theoretical model, implications, and directions for future research. Advances in Health Care Management, 8, 3–20.CrossRefGoogle Scholar