No link between burnout and patient volume
The current research also highlighted leadership style as a potential driver of burnout.
Dr. Edwards and colleagues found that one of the strongest associations was between facilitative leadership and low burnout. Zero burnout is associated with participatory decision-making.
“Interestingly, we saw that that kind of leadership could exist in multiple settings,” he said. Health care professionals in smaller practices might know each other better and have a shared mission, but shared decision making can also exist in larger practices, he said.
Higher burnout was associated with traditional leadership models that are hierarchical and that operate with a command-and-control structure, according to the study.
The data may have implications for strategies regarding both the smallest and largest practices.
Initiatives that help small practices remain strong are valuable, especially for communities that depend on those practices, Dr. Edwards said.
The researchers give as an example the funding of primary care practice extension networks, which provide support similar to agricultural extension programs for farmers.
At the same time, “having agency at the practice level about how things work is really important in reducing burnout. So in a large system, finding ways to promote agency at the most local level possible can really help with burnout,” he said.
Dr. Edwards said his team controlled for the fact that mathematically, it’s more likely zero burnout would be reported in a solo practice than in a larger practice.
Every practice in this study, he said, had to have at least three persons who responded to the survey, and responses had to represent three roles – a clinician, a nonclinician staff member, and a clinical staff member. The response rate also had to be 50% within the practice, he explained.
All authors are supported by the Agency for Healthcare Research and Quality. Dr. Edwards was also supported by the Department of Veterans Affairs Health Services Research and Development. Dr. Goldberg has disclosed no relevant financial relationships.
A version of this article first appeared on Medscape.com.