• J Am Board Fam Med · Mar 2024

    Physician and Advanced Practice Clinician Burnout in Rural and Urban Settings.

    • Melissa L Harry, Nancy L Sudak, Mary J Engels, Karly K Horn, Kate Dean, Sara Poplau, Martin J Stillman, and Mark Linzer.
    • From the Essentia Institute of Rural Health, Essentia Health, Duluth, MN (MLH, KD), Office of Well-Being, Essentia Health, Duluth, MN (NLS, MJE, KKH), Institute for Professional Worklife, Hennepin Healthcare, Minneapolis, MN (SP, MJS, ML). Melissa.Harry@EssentiaHealth.org.
    • J Am Board Fam Med. 2024 Mar 11; 37 (1): 435843-58.

    IntroductionRecruiting rural-practicing clinicians is a high priority. In this study, we explored burnout and contributing work conditions among rural, urban, and family practice physicians and advanced practice clinicians (APCs) in an Upper Midwestern health care system.MethodsThe Mini Z burnout reduction measure was administered by anonymous electronic survey in March 2022. We conducted bivariate analyses of study variables, then assessed relationships of study variables to burnout with multivariate binary logistic regression.ResultsOf 1118 clinicians (63% response rate), 589 physicians and 496 APCs were included in this study (n = 1085). Most were female (56%), physicians (54%), and White (86%), while 21% were in family practice, 46% reported burnout, and 349 practiced rurally. Rural and urban clinician burnout rates were comparable (45% vs 47%). Part-time work protected against burnout for family practice and rural clinicians, but not urban clinicians. In multivariate models for rural clinicians, stress (OR: 8.53, 95% CI: 4.09 to 17.78, P < .001), lack of workload control (OR: 3.06, 95% CI: 1.47-6.36, P = .003), busy/chaotic environments (OR: 2.53, 95% CI: 1.29-4.99, P = .007), and intent to leave (OR: 2.18, 95% CI: 1.06-4.45, P = .033) increased burnout odds. In family practice clinicians, stress (OR: 13.43 95% CI: 4.90-36.79, P < .001) also significantly increased burnout odds.ConclusionsBurnout was comparable between rural and urban physicians and APCs. Part-time work was associated with decreased burnout in rural and family practice clinicians. Addressing burnout drivers (stress, workload control, chaos) may improve rural work environments, reduce turnover, and aid rural clinician recruitment. Addressing stress may be particularly impactful in family practice.© Copyright 2024 by the American Board of Family Medicine.

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