TY - JOUR
T1 - Physician burnout and patient-physician communication during primary care encounters
AU - Ratanawongsa, Neda
AU - Roter, Debra
AU - Beach, Mary Catherine
AU - Laird, Shivonne L.
AU - Larson, Susan M.
AU - Carson, Kathryn A.
AU - Cooper, Lisa A.
PY - 2008/10/1
Y1 - 2008/10/1
N2 - BACKGROUND: Although previous studies suggest an association between provider burnout and suboptimal self-reported communication, no studies relate physician burnout to observed patient-physician communication behaviors. OBJECTIVE: To investigate the relationship between physician burnout and observed patient-physician communication outcomes in patient-physician encounters. DESIGN: Longitudinal study of enrollment data from a trial of interventions to improve patient adherence to hypertension treatment. SETTING: Fifteen urban community-based clinics in Baltimore, MD. PARTICIPANTS: Forty physicians and 235 of their adult hypertensive patients, with oversampling of ethnic minorities and poor persons. Fifty-three percent of physicians were women, and the average practice experience was 11.2 years. Among the 235 patients, 66% were women, 60% were African-American, and 90% were insured. MEASUREMENTS: Audiotape analysis of communication during outpatient encounters (one per patient) using the Roter Interaction Analysis System and patients' ratings of satisfaction with and trust and confidence in the physician. RESULTS: The median time between the physician burnout assessment and the patient encounter was 15.1 months (range 5.6-30). Multivariate analyses revealed no significant differences in physician communication based on physician burnout. However, compared with patients of low-burnout physicians, patients of high-burnout physicians gave twice as many negative rapport-building statements (incident risk ratio 2.06, 95% CI 1.58 - 2.86, p<0.001). Physician burnout was not significantly associated with physician or patient affect, patient-centeredness, verbal dominance, or length of the encounter. Physician burnout was also not significantly associated with patients' ratings of their satisfaction, confidence, or trust. CONCLUSIONS: Physician burnout was not associated with physician communication behaviors nor with most measures of patient-centered communication. However, patients engaged in more rapport-building behaviors. These findings suggest a complex relationship between physician burnout and patient-physician communication, which should be investigated and linked to patient outcomes in future research.
AB - BACKGROUND: Although previous studies suggest an association between provider burnout and suboptimal self-reported communication, no studies relate physician burnout to observed patient-physician communication behaviors. OBJECTIVE: To investigate the relationship between physician burnout and observed patient-physician communication outcomes in patient-physician encounters. DESIGN: Longitudinal study of enrollment data from a trial of interventions to improve patient adherence to hypertension treatment. SETTING: Fifteen urban community-based clinics in Baltimore, MD. PARTICIPANTS: Forty physicians and 235 of their adult hypertensive patients, with oversampling of ethnic minorities and poor persons. Fifty-three percent of physicians were women, and the average practice experience was 11.2 years. Among the 235 patients, 66% were women, 60% were African-American, and 90% were insured. MEASUREMENTS: Audiotape analysis of communication during outpatient encounters (one per patient) using the Roter Interaction Analysis System and patients' ratings of satisfaction with and trust and confidence in the physician. RESULTS: The median time between the physician burnout assessment and the patient encounter was 15.1 months (range 5.6-30). Multivariate analyses revealed no significant differences in physician communication based on physician burnout. However, compared with patients of low-burnout physicians, patients of high-burnout physicians gave twice as many negative rapport-building statements (incident risk ratio 2.06, 95% CI 1.58 - 2.86, p<0.001). Physician burnout was not significantly associated with physician or patient affect, patient-centeredness, verbal dominance, or length of the encounter. Physician burnout was also not significantly associated with patients' ratings of their satisfaction, confidence, or trust. CONCLUSIONS: Physician burnout was not associated with physician communication behaviors nor with most measures of patient-centered communication. However, patients engaged in more rapport-building behaviors. These findings suggest a complex relationship between physician burnout and patient-physician communication, which should be investigated and linked to patient outcomes in future research.
KW - Patient-provider communication
KW - Patient-provider relationship
KW - Physician burnout
KW - Physician well-being
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U2 - 10.1007/s11606-008-0702-1
DO - 10.1007/s11606-008-0702-1
M3 - Article
C2 - 18618195
AN - SCOPUS:51649086842
VL - 23
SP - 1581
EP - 1588
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
SN - 0884-8734
IS - 10
ER -