Physician and Advanced Practice Clinician Burnout in Rural and Urban Settings

References

1. 1.↵
   1. Amanullah S,
   2. Ramesh Shankar R

   . The impact of COVID-19 on physician burnout globally: a review. Healthcare (Basel) 2020;8:421.

   OpenUrl
2. 2.
   Office of the Surgeon General. Addressing health worker burnout: the U.S. Surgeon General’s advisory on building a thriving health workforce. 2022. Available at: https://www.hhs.gov/sites/default/files/health-worker-wellbeing-advisory.pdf.
3. 3.↵
   1. Sharifi M,
   2. Asadi-Pooya A,
   3. Mousavi-Roknabadi R

   . Burnout among healthcare providers of COVID-19; a systematic review of epidemiology and recommendations. Arch Acad Emerg Med 2021;9:e7e7.
4. 4.↵
   World Health Organization. Burn-out an “occupational phenomenon”: International Classification of Diseases. Updated 28 May 2019. Accessed August 5, 2023. Available at: https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases.
5. 5.↵
   World Health Organization (WHO). International classification of diseases, eleventh revision (ICD-11). Updated Jan 2023. Accessed August 5, 2023. Available at: https://icd.who.int/browse11.
6. 6.↵
   1. Prasad K,
   2. McLoughlin C,
   3. Stillman M,
   4. et al

   . Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: A national cross-sectional survey study. EClinicalMedicine 2021;35:100879.

   OpenUrl
7. 7.↵
   1. Linzer M,
   2. Jin J,
   3. Shah P,
   4. et al

   . Trends in clinician burnout with associated mitigating and aggravating factors during the COVID-19 pandemic. JAMA Health Forum 2022;3:e224163.

   OpenUrl
8. 8.↵
   1. Sinsky C,
   2. Brown R,
   3. Stillman M,
   4. Linzer M

   . COVID-related stress and work intentions in a sample of US health care workers. Mayo Clin Proc Innov Qual Outcomes 2021;5:1165–73.

   OpenUrl
9. 9.↵
   1. Litz B,
   2. Stein N,
   3. Delaney E,
   4. et al

   . Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clin Psychol Rev 2009;29:695–706.

   OpenUrlCrossRefPubMed
10. 10.↵
    1. Amsalem D,
    2. Lazarov A,
    3. Markowitz J,
    4. et al

    . Psychiatric symptoms and moral injury among US healthcare workers in the COVID-19 era. BMC Psychiatry 2021;21:546.

    OpenUrl
11. 11.↵
    1. Song Y,
    2. Mantri S,
    3. Lawson J,
    4. Berger E,
    5. Koenig H

    . Morally injurious experiences and emotions of health care professionals during the COVID-19 pandemic before vaccine availability. JAMA Netw Open 2021;4:e2136150.

    OpenUrl
12. 12.↵
    1. Bridgeman P,
    2. Bridgeman M,
    3. Barone J

    . Burnout syndrome among healthcare professionals. Am J Health Syst Pharm 2018;75:147–52.

    OpenUrlFREE Full Text
13. 13.↵
    1. Dyrbye L,
    2. Shanafelt T,
    3. Sinsky C

    , Mayo Clinicet al. Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high quality care. NAM Perspectives Discussion Paper 2017;7.
14. 14.
    1. Lacy B,
    2. Chan J

    . Physician burnout: the hidden health care crisis. Clin Gastroenterol Hepatol 2018;16:311–7.

    OpenUrlCrossRefPubMed
15. 15.
    1. Patel R,
    2. Bachu R,
    3. Adikey A,
    4. Malik M,
    5. Shah M

    . Factors related to physician burnout and its consequences: a review. Behav Sci (Basel) 2018;8:98.

    OpenUrl
16. 16.
    1. Romani M,
    2. Ashkar K

    . Burnout among physicians. Libyan J Med 2014;9:23556.

    OpenUrl
17. 17.
    1. Shanafelt T,
    2. Noseworthy J

    . Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. Mayo Clin Proc 2017;92:129–46.

    OpenUrlCrossRefPubMed
18. 18.↵
    1. Woo T,
    2. Ho R,
    3. Tang A,
    4. Tam W

    . Global prevalence of burnout symptoms among nurses: a systematic review and meta-analysis. J Psychiatr Res 2020;123:9–20.

    OpenUrlCrossRefPubMed
19. 19.↵
    National Academies of Sciences E, and Medicine, Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being. Taking action against clinician burnout: a systems approach to professional well-being. 2019. Available at: https://nap.nationalacademies.org/catalog/25521/taking-action-against-clinician-burnout-a-systems-approach-to-professional.
20. 20.↵
    1. Shanafelt T,
    2. West C,
    3. Dyrbye L,
    4. et al

    . Changes in burnout and satisfaction with work-life integration in physicians during the first 2 years of the COVID-19 pandemic. Mayo Clin Proc 2022;97:2248–58.

    OpenUrl
21. 21.↵
    1. Shanafelt T,
    2. West C,
    3. Sinsky C,
    4. et al

    . Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2017. Mayo Clin Proc 2019;94:1681–94.

    OpenUrlCrossRefPubMed
22. 22.↵
    1. West C,
    2. Dyrbye L,
    3. Shanafelt T

    . Physician burnout: contributors, consequences and solutions. J Intern Med 2018;283:516–29.

    OpenUrlCrossRefPubMed
23. 23.↵
    1. Dutheil F,
    2. Aubert C,
    3. Pereira B,
    4. et al

    . Suicide among physicians and health-care workers: a systematic review and meta-analysis. PLoS One 2019;14:e0226361.

    OpenUrlCrossRefPubMed
24. 24.↵
    1. Sibeoni J,
    2. Bellon-Champel L,
    3. Mousty A,
    4. Manolios E,
    5. Verneuil L,
    6. Revah-Levy A

    . Physicians' perspectives about burnout: a systematic review and metasynthesis. J Gen Intern Med 2019;34:1578–90.

    OpenUrl
25. 25.↵
    1. Center C,
    2. Davis M,
    3. Detre T,
    4. et al

    . Confronting depression and suicide in physicians: a consensus statement. JAMA 2003;289:3161–6.

    OpenUrlCrossRefPubMedWeb of Science
26. 26.↵
    1. Hoff T,
    2. Carabetta S,
    3. Collinson G

    . Satisfaction, burnout, and turnover among nurse practitioners and physician assistants: a review of the empirical literature. Med Care Res Rev 2019;76:3–31.

    OpenUrlCrossRefPubMed
27. 27.↵
    1. Dyrbye L,
    2. Johnson P,
    3. Johnson L,
    4. et al

    . Efficacy of the Well-Being Index to identify distress and stratify well-being in nurse practitioners and physician assistants. J Am Assoc Nurse Pract 2019;31:403–12.

    OpenUrl
28. 28.↵
    1. Hogue A,
    2. Huntington M

    . Family physician burnout rates in rural versus metropolitan areas: a pilot study. S D Med 2019;72:306–8.

    OpenUrl
29. 29.↵
    1. Benson M,
    2. Peterson T,
    3. Salazar L,
    4. et al

    . Burnout in rural physician assistants: an initial study. J Physician Assist Educ 2016;27:81–3.

    OpenUrl
30. 30.↵
    1. Hansen N,
    2. Jensen K,
    3. MacNiven I,
    4. Pollock N,
    5. D'Hont T,
    6. Chatwood S

    . Exploring the impact of rural health system factors on physician burnout: a mixed-methods study in Northern Canada. BMC Health Serv Res 2021;21:869.

    OpenUrl
31. 31.↵
    1. Linzer M,
    2. McLoughlin C,
    3. Poplau S,
    4. Goelz E,
    5. Brown R,
    6. Sinsky C

    , AMA-Hennepin Health System (HHS) burnout reduction writing team. The Mini Z worklife and burnout reduction instrument: Psychometrics and clinical implications. J Gen Intern Med 2022;37:2876–8.

    OpenUrl
32. 32.
    1. Linzer M,
    2. Manwell LB,
    3. Williams ES

    , MEMO (Minimizing Error, Maximizing Outcome) Investigatorset al. Working conditions in primary care: physician reactions and care quality. Ann Intern Med 2009;151:28–36., w6-9.

    OpenUrlCrossRefPubMedWeb of Science
33. 33.↵
    1. Linzer M,
    2. Poplau S,
    3. Grossman E,
    4. et al

    . A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) study. J Gen Intern Med 2015;30:1105–11.

    OpenUrlCrossRefPubMed
34. 34.↵
    1. Linzer M,
    2. Poplau S,
    3. Babbott S,
    4. et al

    . Worklife and wellness in academic general internal medicine: results from a national survey. J Gen Intern Med 2016;31:1004–10.

    OpenUrlCrossRefPubMed
35. 35.↵
    1. Schmoldt R,
    2. Freeborn D,
    3. Klevit H

    . Physician burnout: recommendations for HMO managers. HMO Pract 1994;8:58–63.

    OpenUrlPubMed
36. 36.↵
    1. Rohland B,
    2. Kruse G,
    3. Rohrer J

    . Validation of a single-item measure of burnout against the Maslach Burnout Inventory among physicians. Stress and Health: Journal of the International Society for the Investigation of Stress 2004;20:75–9.

    OpenUrl
37. 37.↵
    1. Maslach C,
    2. Jackson S,
    3. Leiter M

    . Maslach Burnout Inventory Manual 3rd ed. Consulting Psychologists Press; 1996.
38. 38.↵
    1. Funk C,
    2. Parker K

    . Women and men in STEM often at odds over workplace equity. 2018. Available at: https://www.pewresearch.org/social-trends/wp-content/uploads/sites/3/2018/01/PS_2018.01.09_STEM_FINAL.pdf.
39. 39.↵
    1. Audi C,
    2. Poplau S,
    3. Freese R,
    4. Heegaard W,
    5. Linzer M,
    6. Goelz E

    . Negative experiences due to gender and/or race: a component of burnout in women providers within a safety-net hospital. J Gen Intern Med 2021;36:840–2.

    OpenUrlPubMed
40. 40.↵
    1. Williams E,
    2. Konrad T,
    3. Linzer M,
    4. et al

    . Refining the measurement of physician job satisfaction: results from the Physician Worklife Survey. SGIM Career Satisfaction Study Group. Society of General Internal Medicine. Med Care 1999;37:1140–54.

    OpenUrlCrossRefPubMedWeb of Science
41. 41.↵
    1. Babbott S,
    2. Manwell L,
    3. Brown R,
    4. et al

    . Electronic medical records and physician stress in primary care: results from the MEMO Study. J Am Med Inform Assoc 2014;21:e100-106–e106.

    OpenUrl
42. 42.↵
    1. Buchbinder S,
    2. Wilson M,
    3. Melick C,
    4. Powe N

    . Primary care physician job satisfaction and turnover. Am J Manag Care 2001;7:701–13.

    OpenUrlPubMedWeb of Science
43. 43.
    1. Hann M,
    2. Reeves D,
    3. Sibbald B

    . Relationships between job satisfaction, intentions to leave family practice and actually leaving among family physicians in England. Eur J Public Health 2011;21:499–503.

    OpenUrlCrossRefPubMedWeb of Science
44. 44.↵
    1. Rittenhouse D,
    2. Mertz E,
    3. Keane D,
    4. Grumbach K

    . No exit: an evaluation of measures of physician attrition. Health Serv Res 2004;39:1571–88.

    OpenUrlCrossRefPubMedWeb of Science
45. 45.↵
    SurveyMonkey. SurveyMonkey Inc.; 1999-2023. Available at: http://www.surveymonkey.com.
46. 46.↵
    United States Department of Agriculture. Rural-Urban Commuting Area Codes. Updated Aug 17, 2020. Accessed June 16, 2022. Available at: https://www.ers.usda.gov/data-products/rural-urban-commuting-area-codes/.
47. 47.
    1. Aboumrad M,
    2. Peritz D,
    3. Friedman S,
    4. Zwain G,
    5. Watts BV,
    6. Taub C

    . Rural-urban trends in health care utilization, treatment, and mortality among US veterans with congestive heart failure: a retrospective cohort study. J Rural Health 2023;39:844–52.

    OpenUrl
48. 48.↵
    U.S. Department of Veterans Affairs, Office of Rural Health. Rural veterans. Updated March 31. Accessed May 2, 2023. Available at: https://www.ruralhealth.va.gov/aboutus/ruralvets.asp.
49. 49.↵
    1. Chan YH

    . Biostatistics 104: correlational analysis. Singapore Med J 2003;44:614–9.

    OpenUrlPubMed
50. 50.↵
    1. McKelvey R,
    2. Zavoina W

    . A statistical model for the analysis of ordinal level dependent variables. J Math Sociol 1975;4:103–20.

    OpenUrlCrossRefWeb of Science
51. 51.↵
    Stata BE Statistical Software: Release 17. StataCorp, LLC; 1985–2021.
52. 52.↵
    1. Linzer M,
    2. Visser M,
    3. Oort F,
    4. Smets E,
    5. McMurray J,
    6. de Haes H

    , Society of General Internal Medicine (SGIM) Career Satisfaction Study Group (CSSG). Predicting and preventing physician burnout: results from the United States and the Netherlands. Am J Med 2001;111:170–5.

    OpenUrlCrossRefPubMedWeb of Science
53. 53.↵
    1. Linzer M,
    2. Konrad T,
    3. Douglas J,
    4. et al

    . Managed care, time pressure, and physician job satisfaction: results from the physician worklife study. J Gen Intern Med 2000;15:441–50.

    OpenUrlCrossRefPubMedWeb of Science
54. 54.↵
    1. Edwards S,
    2. Marino M,
    3. Balasubramanian B,
    4. et al

    . Burnout among physicians, advanced practice clinicians and staff in smaller primary care practices. J Gen Intern Med 2018;33:2138–46.

    OpenUrlCrossRef
55. 55.↵
    1. Edwards S,
    2. Marino M,
    3. Solberg L,
    4. et al

    . Cultural and structural features of zero-burnout primary care practices. Health Aff (Millwood) 2021;40:928–36.

    OpenUrlCrossRef
56. 56.↵
    1. Bogaert K,
    2. Leider J,
    3. Castrucci B,
    4. Sellers K,
    5. Whang C

    . Considering leaving, but deciding to stay: a longitudinal analysis of intent to leave in public health. J Public Health Manag Pract 2019;25 Suppl 2, Public Health Workforce Interests and Needs Survey 2017:S78–S86.

    OpenUrl