Respondent-Reported Physician and Practice Site Characteristics by Burnout and Perceived Clinic Social Determinants of Health Capacity Among 1298 Family Physicians Applying for Continuous Certification with the American Board of Family Medicine in 2016*
| Variable | Total (N = 1298) N (%) | Burnout | Clinic SDH Capacity | ||||
|---|---|---|---|---|---|---|---|
| Burned Out (N = 481) N (%) | Not Burned Out (N = 1444) N (%) | P Value | High SDH Capacity (N = 589) N (%) | Not High SDH Capacity (N = 709) N (%) | P Value | ||
| Age (years) | |||||||
| ≤45 | 336 (25.9) | 103 (29.3) | 233 (24.6) | 168 (23.7) | 168 (28.5) | ||
| 46–55 | 518 (39.9) | 141 (40.2) | 377 (39.8) | 232 (40.3) | 286 (39.4) | ||
| ≥56 | 444 (34.2) | 107 (30.5) | 337 (35.6) | .12 | 189 (36.0) | 255 (32.1) | .11 |
| Sex† | |||||||
| Male | 573 (44.1) | 175 (49.9) | 398 (42.0) | 264 (44.8) | 325 (43.6) | ||
| Female | 725 (55.9) | 176 (50.1) | 549 (58.0) | .012‡ | 325 (55.2) | 400 (56.4) | .65 |
| Years in Practice | |||||||
| ≤13 | 3137 (32.7) | 120 (34.2) | 305 (32.2) | 223 (37.9) | 202 (28.5) | ||
| 14–21 | 2989 (32.1) | 120 (34.2) | 297 (31.4) | 185 (31.4) | 232 (32.7) | ||
| ≥22 | 3449 (35.1) | 111 (31.6) | 345 (36.4) | .27 | 181 (30.7) | 275 (38.8) | .0010‡ |
| Race | |||||||
| White | 931 (71.73) | 265 (75.5) | 666 (70.3) | 386 (65.5) | 545 (76.9) | ||
| Non-white | 367 (28.3) | 86 (24.5) | 281 (29.7) | .066 | 203 (34.5) | 164 (23.1) | <.0001‡ |
| Ethnicity | |||||||
| Hispanic | 78 (6.01) | 13 (3.7) | 65 (6.9) | 40 (6.8) | 38 (5.4) | ||
| Non-Hispanic | 1220 (94.0) | 338 (96.3) | 882 (93.1) | .033† | 549 (93.2) | 671 (94.6) | .28 |
| % Direct patient care: | |||||||
| ≤50% | 139 (10.7) | 33 (9.4) | 106 (11.2) | 71 (12.1) | 68 (9.6) | ||
| 51%–79% | 91 (7.0) | 31 (8.8) | 60 (6.3) | 42 (7.13) | 49 (6.9) | ||
| ≥80% | 1068 (82.3) | 287 (81.8) | 781 (82.5) | .22 | 476 (80.8) | 592 (83.5) | .35 |
| Workload control | |||||||
| Poor | 74 (5.7) | 58 (16.5) | 16 (1.7) | 35 (5.9) | 39 (5.5) | ||
| Marginal | 295 (22.7) | 159 (45.3) | 136 (14.4) | 108 (18.3) | 187 (26.4) | ||
| Satisfactory | 485 (37.4) | 104 (29.6) | 381 (40.2) | 212 (36.0) | 273 (38.5) | ||
| Good | 349 (26.9) | 26 (7.4) | 323 (34.1) | 180 (30.6) | 169 (23.8) | ||
| Optimal | 95 (7.3) | 4 (1.1) | 91 (9.6) | <.0001‡ | 54 (9.17) | 41 (5.8) | <.0001‡ |
| Team efficiency | |||||||
| Poor/Marginal | 104 (8.0) | 62 (17.7) | 42 (4.4) | 33 (5.6) | 71 (10.0) | ||
| Satisfactory | 306 (23.6) | 114 (32.5) | 192 (20.3) | 106 (18.0) | 200 (28.2) | ||
| Good | 712 (54.9) | 151 (43.0) | 561 (59.2) | 353 (59.9) | 359 (50.6) | ||
| Optimal | 176 (13.6) | 24 (6.84) | 152 (16.1) | <.0001‡ | 97 (16.5) | 79 (11.1) | <.0001‡ |
| Home EHR time | |||||||
| Excessive | 284 (21.9) | 141 (40.2) | 143 (15.1) | 99 (16.8) | 185 (26.1) | ||
| Moderate | 385 (29.7) | 103 (29.3) | 282 (29.8) | 187 (31.8) | 198 (27.9) | ||
| Satisfactory | 225 (17.3) | 33 (9.4) | 192 (20.3) | 111 (18.9) | 114 (16.1) | ||
| Modest | 170 (13.1) | 32 (9.1) | 138 (14.6) | 82 (13.9) | 88 (12.4) | ||
| Minimal/None | 234 (18.0) | 42 (12.0) | 192 (20.3) | <.0001‡ | 110 (18.7) | 124 (17.5) | .0020‡ |
| EHR proficiency | |||||||
| Poor/Marginal | 79 (6.1) | 31 (8.8) | 48 (5.1) | 29 (4.9) | 50 (7.1) | ||
| Satisfactory | 336 (25.9) | 87 (24.8) | 249 (26.3) | 132 (22.4) | 204 (28.8) | ||
| Good | 653 (50.3) | 176 (50.1) | 477 (50.4) | 310 (52.6) | 343 (48.4) | ||
| Optimal | 230 (17.7) | 57 (16.2) | 173 (18.3) | .079 | 118 (20.0) | 112 (15.8) | .0080‡ |
| Primary practice ownership | |||||||
| Private | 767 (59.1) | 201 (57.3) | 566 (59.8) | 304 (51.6) | 463 (65.3) | ||
| Hospital or HMO based | 309 (23.8) | 84 (23.9) | 225 (23.8) | 142 (24.1) | 167 (23.6) | ||
| FQHC and similar | 136 (10.5) | 40 (11.4) | 96 (10.1) | 81 (13.8) | 55 (7.8) | ||
| Other | 86 (6.6) | 26 (7.4) | 60 (6.3) | .78 | 62 (10.5) | 24 (3.4) | <.0001‡ |
| Pharmacist on staff | 255 (19.7) | 75 (21.4) | 180 (19.0) | .34 | 175 (29.7) | 80 (11.3) | <.0001‡ |
| Social work on staff | 241 (18.6) | 67 (19.1) | 174 (18.4) | .77 | 173 (29.4) | 68 (9.6) | <.0001‡ |
| Behavior specialist on staff | 300 (23.1) | 92 (26.2) | 208 (22.0) | .11 | 191 (32.4) | 109 (15.4) | <.0001‡ |
| Psychiatrist on staff | 142 (10.9) | 44 (12.5) | 98 (10.4) | .26 | 100 (45.4) | 42 (5.9) | <.0001‡ |
| PCMH stage | |||||||
| Not applying | 435 (33.5) | 113 (32.2) | 322 (34.0) | 171 (29.0) | 264 (37.2) | ||
| Applying | 299 (23.0) | 80 (22.8) | 219 (23.1) | 110 (18.7) | 189 (26.7) | ||
| Recognized | 564 (43.5) | 158 (45.0) | 406 (42.9) | .77 | 308 (52.3) | 256 (36.1) | <.0001‡ |
| Vulnerable patient population† | |||||||
| <10% | 395 (30.4) | 93 (26.5) | 302 (31.9) | 168 (28.5) | 227 (32.0) | ||
| 10%–19% | 343 (26.4) | 101 (28.8) | 242 (25.6) | 137 (23.3) | 206 (29.1) | ||
| ≥20% | 560 (43.1) | 157 (44.7) | 403 (42.6) | .16 | 284 (48.2) | 276 (38.9) | .0030‡ |
↵* See Appendix Table 1 for full results of respondent characteristics.
↵† P < .05 for differences between full sample and study sample.
↵‡ P < .05.
EHR, electronic health record; HMO, health maintenance organization; FQHC, federally qualified health center; SDH, social determinants of health; PCMH, patient-centered medical home.