Burnout and scope of practice in new family physicians

Abstract

PURPOSE Family physicians report some of the highest levels of burnout, but no published work has considered whether burnout is correlated with the broad scope of care that family physicians may provide. We examined the associations between family physician scope of practice and self-reported burnout. METHODS Secondary analysis of the 2016 National Family Medicine Graduate Survey respondents who provided outpatient continuity care (N = 1,617). We used bivariate analyses and logistic regression to compare self-report of burnout and measures of scope of practice including: inpatient medicine, obstetrics, pediatric ambulatory care, number of procedures and/or clinical content areas, and providing care outside the principal practice site. RESULTS Forty-two percent of respondents reported feeling burned out from their work once a week or more. In bivariate analysis, elements of scope of practice associated with higher burnout rates included providing more procedures/ clinical content areas (mean procedures/clinical areas: 7.49 vs 7.02; P =.02) and working in more settings than the principal practice site (1+ additional settings: 57.6% vs 48.4%: P =. 001); specifically in the hospital (31.4% vs 24.2%; P =. 002) and patient homes (3.3% vs 1.5%; P =. 02). In adjusted analysis, practice characteristics significantly associated with lower odds of burnout were practicing inpatient medicine (OR = 0.70; 95% CI, 0.56-0.87; P =. 0017) and obstetrics (OR = 0.64; 95% CI, 0.47-0.88; P =. 0058). CONCLUSIONS Early career family physicians who provide a broader scope of practice, specifically, inpatient medicine, obstetrics, or home visits, reported significantly lower rates of burnout. Our findings suggest that comprehensiveness is associated with less burnout, which is critical in the context of improving access to good quality, affordable care while maintaining physician wellness.