Indicators of Workplace Burnout Among Physicians, Advanced Practice Clinicians, and Staff in Small to Medium-Sized Primary Care Practices

Article Figures & Data

Table 1.

Distribution of Health Care Professional Groups and Burnout (n = 1273)

Parameter	Sample, n (%)	Burnout
Parameter	Sample, n (%)	No, n (%)	Yes, n (%)	P Value^*	OR (95% CI)^† Burnout
Burnout total		1024 (80.1)	249 (19.5)
Health Care Professionals				0.002
Physicians	139 (11.0)	93 (68.4)	43 (31.6)		1.75 (1.09-2.82)
Advanced practice clinicians^‡	99 (7.8)	82 (82.8)	17 (17.2)		1.01 (0.54-1.88)
Clinical support staff^§	451 (35.6)	365 (81.1)	85 (18.9)		1.29 (0.87-1.91)
Administrative staff^‖	578 (45.6)	477 (82.5)	101 (17.5)		Reference

↵* The P value is based on χ² analysis testing the association between burnout and the type of health care professional.
↵† OR stands for odds ratios calculated from a logistic regression model that has been adjusted for practice size, single- or multispecialty practice, whether a practice is located in an underserved area, and number of hours worked per week
↵‡ Advanced practice clinicians include nurse practitioners and physician assistants.
↵§ Clinical support staff includes licensed practical nurses and medical assistants.
↵‖ Administrative staff includes office managers, receptionists, and medical billing professionals.
Bold text indicates statistically significant finding.
OR, odds ratio; CI, confidence interval.

Table 2.

Differences in the Change Diagnostic Index Domains by Health Care Professional Role at the Practice (n = 1273)

Domains of the Change Diagnostic Index	Sample Mean (SD)	Physicians Mean (SD)	Advanced Practice Clinicians^* Mean (SD)	Clinical Support Staff^† Mean (SD)	Administrative Staff^‡ Mean (SD)	P Value
Global	2.19 (0.75)	2.29 (0.82)	2.21 (0.71)	2.19 (0.76)	2.16 (0.73)	0.332
Anxiety	2.50 (0.84)	2.77 (0.88)	2.57 (0.83)	2.46 (0.83)	2.44 (0.83)	0.000
Frustration	1.83 (0.71)	1.76 (0.71)	1.80 (0.73)	1.85 (0.72)	1.83 (0.70)	0.627
Delayed development	2.00 (0.72)	1.98 (0.69)	1.98 (0.66)	2.02 (0.72)	1.99 (0.73)	0.911
Rejection of environment	1.97 (0.75)	2.01 (0.78)	2.04 (0.71)	1.99 (0.77)	1.94 (0.74)	0.438
Refusal	1.74 (0.67)	1.66 (0.64)	1.72 (0.63)	1.78 (0.71)	1.72 (0.64)	0.266
Withdrawal	1.70 (0.70)	1.60 (0.76)	1.69 (0.66)	1.73 (0.72)	1.71 (0.68)	0.353

↵* Advanced practice clinicians include nurse practitioners and physician assistants.
↵† Clinical support staff includes licensed practical nurses and medical assistants.
↵‡ Administrative staff includes office managers, receptionists, and medical billing professionals.
Bold text indicates statistically significant finding.
SD, standard deviation.

Table 3.

Logistic Regression for Burnout among Health Care Professionals Based on the Change Diagnostic Index (n = 1273)

The Change Diagnostic Index	Entire Sample Burnout, OR (95% CI)^*	Physicians Burnout, OR (95% CI)^*	Advanced Practice Clinicians^† Burnout, OR (95% CI)^*	Clinical Support Staff^‡ Burnout, OR (95% CI)^*	Administrative Staff^§ Burnout, OR (95% CI)^*
Global	0.83 (0.55–1.23)	1.19 (0.43–3.34)	0.22 (0.02–2.24)	0.76 (0.37–1.55)	0.90 (0.49–1.69)
Anxiety	2.26 (1.67–3.07)	3.22 (1.42–7.31)	7.97 (1.74–36.5)	1.65 (1.02–2.73)	2.31 (1.39–3.85)
Frustration	1.64 (1.05–2.56)	3.46 (0.65–18.4)	4.25 (0.07–245.1)	1.32 (0.72–2.42)	2.04 (0.89–4.65)
Delayed development	2.03 (1.34–3.08)	0.65 (0.22–1.96)	8.45 (0.22–326.7)	3.89 (1.79–8.49)	2.02 (1.01–4.02)
Rejection of environment	1.85 (1.16–2.93)	1.93 (0.75–4.93)	57.2 (1.56–2109.2)	1.69 (0.89–3.21)	1.33 (0.57–3.07)
Refusal	0.76 (0.47–1.23)	0.61 (0.12–3.07)	0.01 (0.0004–3.41)	0.82 (0.44–1.53)	0.83 (0.39–1.71)
Withdrawal	1.09 (0.75–1.59)	4.15 (1.18–14.5)	3.52 (0.38–32.3)	0.78 (0.39–1.59)	0.97 (0.51–1.87)

↵* Adjusted for practice size, single- or multispecialty practice, whether a practice is located in an underserved area, and number of hours worked per week.
↵† Advanced practice clinicians include nurse practitioners and physician assistants.
↵‡ Clinical support staff includes licensed practical nurses and medical assistants.
↵§ Administrative staff includes office managers, receptionists, and medical billing professionals.
Bold text indicates a statistically significant finding.
OR, odds ratio; CI, confidence interval.