Clifton et al. on burnout

Congratulations to Faculty Associate Jessica Clifton, PhD, who led a team in writing up the first results on staff burnout from Integrating Behavioral Health and Primary Care. The work has been accepted for publication in the Journal of the American Board of Family Medicine. The article will appear on November 11, but the abstract is now online.

Differences in Occupational Burnout Among Primary Care Professionals: A Cross-Sectional Study

Jessica Clifton, PhD; Levi Bonnell, MPH; Juvena Hitt, MPH; Abigail Crocker, PhD; Gail L. Rose, PhD; Constance van Eeghen, DrPH; Rodger Kessler, PhD; Kari A. Stephens, PhD; Kathryn Teng MD; Janeen Leon, MS, RDN, LD; Brenda Mollis, MPA, MPH; Benjamin Littenberg, MD

Background: Occupational burnout is a major concern for personal well-being and patient care. We examined burnout among primary care providers (PCPs), medical residents, behavioral health providers (BHPs), nurses, and other clinical and non-clinical primary care team members. Methods: This was a cross-sectional study, nested within a larger, multi-center randomized trial. A convenience sample of 687 professionals (~63% response rate) at 41 primary care practices with on-site BHPs across 13 states participated. Participants completed a validated nine-item burnout measure with three domains: depersonalization, emotional exhaustion, and personal accomplishment. Multivariable multilevel linear regression with a random intercept for each practice was used to determine mean differences in burnout across professional roles. Data was collected between 2018 and 2019. Results: Overall burnout rates varied by professional role: PCPs 70%, medical residents 89%, BHPs 59%, nurses 66%, other clinicians 68%, and non-clinical professionals 70%. Compared to non-clinical professionals, residents experienced more burnout in more domains, followed by PCPs. PCPs, residents, and nurses reported significantly worse depersonalization and exhaustion scores (B = 1.52 to 2.11 points; P < 0.05). Non-clinical professionals had worse accomplishment scores than all clinical professionals except for residents (B = - 1.29 to -1.76 points; P < 0.03). This study revealed moderate-to-high levels of burnout among primary care professionals. Discussion: Clinicians may be experiencing aspects of burnout more intensely than their non-clinical colleagues, and this may be most true for residents and PCPs. Based on these variations, interventions to mitigate burnout may need to be tailored by professional role.