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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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.
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.
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.
Baker, R. (1990). Development of a questionnaire to assess patients’ satisfaction with consultations in general practice. British Journal of General Practice, 40, 487–490.
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.
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.
Brown, H., & Prescott, R. (2006). Applied mixed models in medicine (2nd ed.). Chichester, West Sussex: Wiley.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Hobfoll, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American Psychologist, 44, 513–524.
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.
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.
Leiter, M. P., Harvie, P., & Frizzell, C. (1998). The correspondence of patient satisfaction and nurse burnout. Social Science and Medicine, 47, 1611–1617.
Leiter, M. P., & Maslach, C. (1988). The impact of interpersonal environment on burnout and organizational commitment. Journal of Organizational Behavior, 9, 297–308.
Maslach, C., & Jackson, S. E. (1986). Maslach Burnout Inventory (Manual) (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.
Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52, 397–422.
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.
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.
Peugh, J. L. (2010). A practical guide to multilevel modeling. Journal of School Psychology, 48, 85–112.
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.
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.
Raudenbush, S., Bryk, A., Cheong, Y. K., Congdon, R., & du Toit, M. (2004). HLM (Version 6) [Computer Software]. Lincolnwood, IL: Scientific Software International, Inc.
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.
Roter, D. (2000). The enduring and evolving nature of the patient- physician relationship. Patient Education and Counseling, 39, 5–15.
Roter, D. (2006). The patient-physician relationship and its implications for malpractice litigation. Journal of Health Care Law and Policy, 9, 304–314.
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.
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.
Schaufeli, W. B., & Taris, T. W. (2005). The conceptualization and measurement of burnout: Common ground and worlds apart. Work and Stress, 19, 256–262.
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.
Stewart, M. A. (1995). Effective physician-patient communication and health outcomes: A review. Canadian Medical Association Journal, 152, 1423–1433.
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.
West, B. T. (2009). Analyzing longitudinal data with the linear mixed models procedure in SPSS. Evaluation and the Health Professions, 32, 207–228.
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.
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.
Williams, E. S., Savage, G. T., & Linzer, M. (2006). A proposed physician-patient cycle model. Stress and Health, 22, 131–137.
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The authors gratefully acknowledge the helpful advice and support offered by Professor Debra Roter.
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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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DOI: https://doi.org/10.1007/s10880-011-9278-8