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Study Finds Higher Morale, Job Satisfaction Associated With PCMH Model
Increased Chance of Physician Burnout Also a Result
The study findings have important implications, according to Nocon. "Workforce is a major issue in primary care. Satisfaction, morale and burnout are key factors that drive whether there is a workforce in place to provide care."
- A recent study links the patient-centered medical home (PCMH) model to high staff and physician morale and job satisfaction.
- The study also notes, however, that PCMH adoption increases chances of physician burnout.
- Study researchers speculate that increased chances of burnout could be a result of the work and changes required to implement the PCMH.
The study is based on a 2010 survey of physicians and clinical staff members working at 65 safety net clinics in five states: Colorado, Massachusetts, Idaho, Pennsylvania and Oregon. All of the safety-net clinics are participating in a five-year Commonwealth Fund project to help the clinics transform into high-functioning PCMHs, according to Nocon. The project is scheduled to end in 2013.
Researchers mailed the survey to 391 physicians and other professionals and 382 clinical staff at the 65 clinics. They received 603 completed surveys, for an overall response rate of 78 percent. The response rate for physicians and other professionals was 79.8 percent, and for staff it was 76.2 percent.
The survey used five subscales to measure respondents' perceptions of PCMH characteristics within their respective clinics on a scale of zero to 100 -- zero being the worst and 100 the best. These five subscales were
- access to care and communication with patients,
- communication with other health care professionals,
- tracking data,
- care management, and
- quality improvement.
The survey found that a 10 percent increase in how respondents rated PCMH characteristics translated into higher rates of morale. "For example, let's say you have two people who are exactly the same in all other aspects except the way they rated the medical home," says Nocon. "The person who rates the PCMH quality improvement subscale 10 percent higher on the zero to 100 scale has over two-and-a-half times higher odds of having good morale."
The survey also queried respondents about burnout, asking them to what extent they agreed or disagreed with the following statements:
- I feel completely burned out and wonder if I can go on.
- The symptoms of burnout that I'm experiencing won't go away. I think about frustrations at work a lot.
- I have one or more symptoms of burnout, such as physical or emotional exhaustion.
- Occasionally I am under stress at work, but I don't feel burned out.
- I enjoy my work. I have no symptoms of burnout.
Perhaps most importantly, higher PCMH scores translated into higher rates of burnout, demonstrating a clear association between PCMH characteristics and job burnout, according to the study. The study results showed that physicians and other health professionals who rate their clinic's medical home function 10 percent higher had twice the odds of experiencing burnout.
"Core components of the PCMH include comprehensive primary care, quality improvement, care management and enhanced access," the study states. "For many practices, the (PCMH) model may increase workload and significantly change staff roles. Therefore, providers and staff may be strained by the transformation that occurs with implementation of the PCMH."
The study authors say that "PCMH models may be helpful for improving provider and staff satisfaction, increasing the primary care workforce and reducing turnover." But they warn that burnout in PCMH practices must be monitored.
Patient-Centered Medical Home