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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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Abstract

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.

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References

  • Aikens, J. E., Bingham, R., & Piette, J. D. (2005). Patient-provider communication and self-care behavior among type 2 diabetes patients. Diabetes Educator, 31, 681–690.

    Article  PubMed  Google Scholar 

  • 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 

  • Argentero, P., Dell’Olivo, B., & Santa Ferretti, M. (2008). Staff burnout and patient satisfaction with the quality of dialysis care. American Journal of Kidney Diseases, 51, 80–92.

    Article  PubMed  Google Scholar 

  • Baker, R. (1990). Development of a questionnaire to assess patients’ satisfaction with consultations in general practice. British Journal of General Practice, 40, 487–490.

    PubMed  CAS  Google Scholar 

  • Bakker, A. B., Schaufeli, W. B., Sixma, H. J., Bosveld, W., & van Dierendonck, D. (2000). Patient demands, lack of reciprocity, and burnout: A five-year longitudinal study among general practitioners. Journal of Organizational Behavior, 21, 425–441.

    Article  Google Scholar 

  • Beck, R. S., Daughtridge, R., & Sloane, P. D. (2002). Physician-patient communication in the primary care office: A systematic review. Journal of the American Board of Family Practice, 15, 25–38.

    PubMed  Google Scholar 

  • Brown, H., & Prescott, R. (2006). Applied mixed models in medicine (2nd ed.). Chichester, West Sussex: Wiley.

    Book  Google Scholar 

  • Cheraghi-Sohi, S., Hole, A. R., Mead, N., McDonald, R., Whalley, D., Bower, P., et al. (2008). What patients want from primary care consultations: A discrete choice experiment to identify patients’ priorities. Annals of Family Medicine, 6, 107–115.

    Article  PubMed  Google Scholar 

  • Demerouti, E., Bakker, A. B., Nachreiner, F., & Schaufeli, W. B. (2001). The job demands-resources model of burnout. Journal of Applied Psychology, 86, 499–512.

    Article  PubMed  CAS  Google Scholar 

  • Garman, A. N., Corrigan, P. W., & Morris, S. (2002). Staff burnout and patient satisfaction: Evidence of relationships at the care unit level. Journal of Occupational Health Psychology, 7, 235–241.

    Article  PubMed  Google Scholar 

  • Hakanen, J. J., Schaufeli, W. B., & Ahola, K. (2008). The job demands-resources model: A three-year cross-lagged study of burnout, depression, commitment, and work engagement. Work and Stress, 22, 224–241.

    Article  Google Scholar 

  • Halbesleben, J. R. B. (2006). Patient reciprocity and physician burnout: What do patients bring to the patient-physician relationship? Health Services Management Research, 19, 215–222.

    Article  PubMed  Google Scholar 

  • Halbesleben, J. R. B., & Rathert, C. (2008). Linking physician burnout and patient outcomes: Exploring the dyadic relationship between physicians and patients. Health Care Management Review, 33, 29–39.

    Article  PubMed  Google Scholar 

  • Hall, J. A., Horgan, T. G., Stein, T. S., & Roter, D. L. (2002). Liking in the physician-patient relationship. Patient Education and Counseling, 48, 69–77.

    Article  PubMed  Google Scholar 

  • Haskard, K. B., Williams, S. L., DiMatteo, M. R., Rosenthal, R., White, M. K., & Goldstein, M. G. (2008). Physician and patient communication training in primary care: Effects on participation and satisfaction. Health Psychology, 27, 513–522.

    Article  PubMed  Google Scholar 

  • Hekkert, K. D., Cihangir, S., Kleefstra, S. M., van den Berg, B., & Kool, R. B. (2009). Patient satisfaction revisited: A multilevel approach. Social Science and Medicine, 69, 68–75.

    Article  PubMed  Google Scholar 

  • Hobfoll, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American Psychologist, 44, 513–524.

    Article  PubMed  CAS  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

  • Kinnersley, P., Stott, N., Peters, T., Harvey, I., & Hackett, P. (1996). A comparison of methods for measuring patient satisfaction with consultations in primary care. Family Practice, 13, 41–51.

    Article  PubMed  CAS  Google Scholar 

  • Leiter, M. P., Harvie, P., & Frizzell, C. (1998). The correspondence of patient satisfaction and nurse burnout. Social Science and Medicine, 47, 1611–1617.

    Article  PubMed  CAS  Google Scholar 

  • Leiter, M. P., & Maslach, C. (1988). The impact of interpersonal environment on burnout and organizational commitment. Journal of Organizational Behavior, 9, 297–308.

    Article  Google Scholar 

  • Maslach, C., & Jackson, S. E. (1986). Maslach Burnout Inventory (Manual) (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52, 397–422.

    Article  PubMed  CAS  Google Scholar 

  • Mead, N., Bower, P., & Hann, M. (2002). The impact of general practitioners’ patient-centredness on patients’ post-consultation satisfaction and enablement. Social Science and Medicine, 55, 283–299.

    Article  PubMed  Google Scholar 

  • Papadatou, D., Anagnostopoulos, F., & Monos, D. (1994). Factors contributing to the development of burnout in oncology nursing. British Journal of Medical Psychology, 67, 187–199.

    Article  PubMed  Google Scholar 

  • Peugh, J. L. (2010). A practical guide to multilevel modeling. Journal of School Psychology, 48, 85–112.

    Article  PubMed  Google Scholar 

  • Poulton, B. C. (1996). Use of the Consultation Satisfaction Questionnaire to examine patients’ satisfaction with general practitioners and community nurses: Reliability, replicability and discriminant validity. British Journal of General Practice, 46, 26–31.

    PubMed  CAS  Google Scholar 

  • Ratanawongsa, N., Roter, D., Beach, M. C., Laird, S. L., Larson, S. M., Carson, K. A., et al. (2008). Physician burnout and patient-physician communication during primary care encounters. Journal of General Internal Medicine, 23, 1581–1588.

    Article  PubMed  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 

  • Rodriguez, H. P., Scoggins, J. F., von Glahn, T., Zaslavsky, A. M., & Safran, D. G. (2009). Attributing sources of variation in patients’ experiences of ambulatory care. Medical Care, 47, 835–841.

    Article  PubMed  Google Scholar 

  • Roter, D. (2000). The enduring and evolving nature of the patient- physician relationship. Patient Education and Counseling, 39, 5–15.

    Article  PubMed  CAS  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.

  • Schaufeli, W. B., Bakker, A. B., Hoogduin, K., Schaap, C., & Kladler, A. (2001). On the clinical validity of the Maslach Burnout Inventory and the burnout measure. Psychology and Health, 16, 565–582.

    Article  PubMed  CAS  Google Scholar 

  • Schaufeli, W. B., Bakker, A. B., & van Rhenen, W. (2009). How changes in job demands and resources predict burnout, work engagement, and sickness absenteeism. Journal of Organizational Behavior, 30, 893–917.

    Article  Google Scholar 

  • Schaufeli, W. B., & Taris, T. W. (2005). The conceptualization and measurement of burnout: Common ground and worlds apart. Work and Stress, 19, 256–262.

    Article  Google Scholar 

  • Shanafelt, T. D., Bradley, K. A., Wipf, J. E., & Back, A. L. (2002). Burnout and self-reported patient care in an internal medicine residency program. Annals of Internal Medicine, 136, 358–367.

    PubMed  Google Scholar 

  • Stewart, M. A. (1995). Effective physician-patient communication and health outcomes: A review. Canadian Medical Association Journal, 152, 1423–1433.

    PubMed  CAS  Google Scholar 

  • 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 

  • West, B. T. (2009). Analyzing longitudinal data with the linear mixed models procedure in SPSS. Evaluation and the Health Professions, 32, 207–228.

    Article  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.

    Article  PubMed  Google 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.

    Article  Google Scholar 

  • Williams, E. S., Savage, G. T., & Linzer, M. (2006). A proposed physician-patient cycle model. Stress and Health, 22, 131–137.

    Article  Google Scholar 

Download references

Acknowledgments

The authors gratefully acknowledge the helpful advice and support offered by Professor Debra Roter.

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Correspondence to Fotios Anagnostopoulos.

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Anagnostopoulos, F., Liolios, E., Persefonis, G. et al. Physician Burnout and Patient Satisfaction with Consultation in Primary Health Care Settings: Evidence of Relationships from a one-with-many Design. J Clin Psychol Med Settings 19, 401–410 (2012). https://doi.org/10.1007/s10880-011-9278-8

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