VA Women's Health Primary Care Providers More Likely to Experience Burnout than General Primary Care Providers
BACKGROUND:
Among all primary care providers (PCPs), increased provider burnout is associated with reduced patient safety, poorer quality of care, and lower quality doctor-patient relationships. Further, burned out PCPs are more likely to leave their jobs. More than 80% of women Veterans are currently cared for by Women’s Health Primary Care Providers (WH-PCPs), which are available at every VA facility. WH-PCPs face distinct challenges compared to general PCPs, including the need for more WH training among providers and staff, as well as a lack of trained staff to care for patients. This study examined differences in burnout and intent to leave practice among VA WH (n=2,751) and general (n=5,152) PCPs. Investigators examined national VA All Employee Survey (AES) and VA practice data for three years (2017-2019), which included more than 140 VA medical centers and 1,000 free-standing outpatient clinics. In addition to answering questions on burnout, respondents also provided responses on demographics, tenure (<1 year to more than 20 years) and supervisory role. Investigators also examined practice characteristics (i.e., teaching affiliation and geographic region).
FINDINGS:
- Across the three years, burnout was higher among women’s health PCPs compared to general PCPs (55% vs 47%), even after accounting for provider and practice characteristics, with a similar proportion considering leaving (33% vs. 32%).
- WH-PCPs who intend to leave their current position are more likely than general PCPs to do so for job-related reasons (e.g., types of work, workload, burnout, boredom).
- Burnout among women’s health providers was similar at facilities with a comprehensive women’s health clinic and those without one.
IMPLICATIONS:
- Working collaboratively with WH-PCPs to understand the causes of burnout and develop solutions is the focus of this study team's current work. Ensuring WH-PCP well-being is essential to providing high quality primary care to women Veterans.
LIMITATIONS:
- Investigators used facility-level averages for workload, staffing, patient complexity, and panel size; however, these averages may not have reflected provider-level variation in these characteristics.
- Investigators only analyzed intent to leave, rather than actual attrition, as an outcome, which may have led to an overestimation of potential PCP attrition.
AUTHOR/FUNDING INFORMATION:
This study was partly funded by HSR&D. Dr. Apaydin was supported by a VA Advanced Fellowship in HSR&D and Dr. Yano by an HSR&D Senior Research Career Scientist Award. Drs. Apaydin, Hamilton, Rose, and Yano (Director) are part of HSR&D’s Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Dr. Mohr is with HSR&D’s Center for Healthcare Organization and Implementation Research (CHOIR), and Dr. Haskell is with HSR&D’s Pain Research, Informatics, Multi-morbidities, and Education Center (PRIME).
Apaydin E, Mohr D, Hamilton A, Rose D, Haskell S, and Yano E. Differences in Burnout and Intent to Leave between Women’s Health and General Primary Care Providers in the Veterans Health Administration. Journal of General Internal Medicine. October 7, 2021; online ahead of print.
