A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study, supported by the federal Agency for Healthcare Research and Quality (AHRQ)
Patients often talk to their physicians about how to manage stress, but studies have shown that physicians in clinic practice are having a difficult time of their own balancing work-life issues, schedules and expectations. Perceived failure at meeting these demands can even lead them to consider leaving their profession.
“With more new patients accessing health care systems, we need every clinician possible to be motivated, connected and functioning at their best,” explains study author Dr. Mark Linzer. “The loss of clinicians to organizations at this point in time can indeed be a disaster.”
In a national study of 34 clinics, half were randomized to worklife interventions and half received no interventions. When assessing clinics where improvement took place, physician burnout or satisfaction was 3.5 to 5.9 times more likely to improve at clinics where interventions were implemented than in clinics where no changes took place. The study identified 3 types of effective programs: 1) workflow redesign, 2) communication improvements (especially between provider groups) and 3) quality improvement projects targeted to clinician concerns. This is the first study to date that has shown a variety of effective interventions in a randomized controlled format, often regarded as the most rigorous of scientific methods.
Dr. Linzer and his associates are now in the process of rolling these data and interventions out nationally through collaborations with the American Medical Association and the American College of Physicians. They are using these processes nationally through a project with the Association of Chiefs and Leaders in General Internal Medicine (ACLGIM), surveying and advising up to 50 divisions throughout the country on the work-life and wellness of their clinicians – and how they can improve their experiences.
“These are people who chose medicine because they wanted to help others, and now they are the ones who need support,” said Dr. Linzer. “Given that need, we focused on interventions that might improve clinicians’ work-life balance or their experiences at work. This study shows that interventions can have a positive effect on clinicians; and the next step in the analyses will determine how much of this impact is transmitted to patients.”
Dr. Mark Linzer is Director of the Division of General Internal Medicine at Hennepin County Medical Center. He is a highly involved clinician, teacher, and researcher. Dr. Linzer has been widely published in peer-reviewed journals, and has been invited to speak on various subjects nationally and internationally.
A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study, supported by AHRQ, will be published in the Journal of General Internal Medicine (JGIM). JGIM is the official journal of the Society of General Internal Medicine. It promotes improved patient care, research, and education in primary care, general internal medicine, and hospital medicine. Its articles focus on clinical medicine, epidemiology, prevention, health care delivery, curriculum development, and some non-traditional themes. JGIM offers early publication on www.SpringerLink.com to reach a broad audience, with online access to abstracts and full articles rapidly growing each year. Learn more about JGIM at http://www.jgim.org/.