New study highlights key insights and solutions to alleviate family physicians' burnout amid EHR and staffing strain
Nearly two-thirds of physicians and half of family physicians are affected by burnout – a key contributor of which is electronic health records (EHR). A new study from UCSF underscores the urgent need for health system leaders to address growing burnout among family physicians, as the combined pressures of increased EHR use and staffing shortages post-pandemic continue to take a toll.
Published in JAMA Network Open on November 5, 2024, the study “Team and Electronic Health Record Features and Burnout Among Family Physicians” was led by Lisa Rotenstein, MD, MBA, MSc, assistant professor in the UCSF Division of Clinical Informatics and Digital Transformation (DoC-IT) and director of the Center to Advance Digital Physician Practice Transformation (ADAPT). She worked in collaboration with Nathaniel Hendrix, PharmD, PhD, researcher and data scientist with the American Board of Family Medicine (ABFM); Robert L. Phillips, MD, MSPH, executive director of ABFM); and Julia Adler-Milstein, PhD, chief of DoC-IT.
The researchers aimed to understand how burnout among family physicians has evolved over time and identify specific factors that could improve their work experience. They conducted this cross-sectional study of over 10,000 family physicians nationwide who answered a subset of questions about burnout each year from 2017-2023. Throughout that period, approximately 40% of physicians reported burnout each year without significant change over time.
"This work emphasizes that burnout – which is known to be associated with physician turnover and lower quality of care – remains a substantial threat to the physician workforce. Based on our findings, we identified concrete structural factors that can potentially enhance the physician experience. Our results thus can serve as a starting point for clinical leaders focused on investing in this important goal."
Lisa Rotenstein, MD, MBA, MSc
Director, Center to Advance Digital Physician Practice Transformation (ADAPT)
Assistant Professor, Division of Clinical Informatics and Digital Transformation (DoC-IT)
Medical Director of Ambulatory Quality and Safety, UCSF Health
The study highlights that fostering appropriate use of EHRs at home, coupled with enhancing team efficiency, can significantly reduce the risk of burnout among family physicians. By identifying key teaming factors that support both effective EHR use and streamlined team dynamics, the research generated key evidence and offers actionable solutions that clinical and operational leaders can use to alleviate burnout and improve overall well-being for primary care and family physicians.
This study was conducted in partnership with the American Board of Family Medicine and with support from The Physicians Foundation.
Read the publication here.
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About the Authors
Lisa Rotenstein, MD, MBA, MSc
Assistant Professor, Division of Clinical Informatics and Digital Transformation (DoC-IT)
Director, Center to Advance Digital Physician Practice Transformation (ADAPT)
Medical Director of Ambulatory Quality and Safety, UCSF Health
Dr. Rotenstein, a primary care physician, researcher, and healthcare leader, specializes in ambulatory care delivery, physician well-being, gender issues in medicine, and the impact of electronic health records (EHR) on medical practice around these topics.
Nathaniel Hendrix, PharmD, PhD
Researcher and Data Scientist, American Board of Family Medicine (ABFM)
Dr. Hendrix’s research focuses on epidemiology with EHRs, natural language processing of clinical notes, and the implementation of artificial intelligence in primary care.
Robert L. Phillips, MD, MSPH
Executive Director, American Board of Family Medicine (ABFM)
Director, ABFM Center for Professionalism and Value in Health Care
Dr. Phillips currently practices in a community-based residency program in Fairfax, Va., and is a professor of family medicine at Georgetown University and Virginia Commonwealth University.
Julia Adler-Milstein, PhD
Chief and Professor, UCSF DoC-IT
Dr. Adler-Milstein is a leading researcher in health IT policy, with a specific focus on electronic health records and interoperability. She has examined policies and organizational strategies that enable effective use of electronic health records and promote interoperability. She is also an expert in EHR audit log data and its application to studying clinician behavior. Her research – used by researchers, health systems, and policymakers – identifies obstacles to progress and ways to overcome them.
About the UCSF Division of Clinical Informatics and Digital Transformation (DoC-IT)
DoC-IT serves as the academic home for applied clinical informatics researchers within the UCSF Department of Medicine. We also serve as a coordinating entity with key internal and external digital stakeholders across all UCSF mission areas, schools, departments, and divisions. Clinical informatics is approached as a multidisciplinary field that involves the use of technology by a broad spectrum of health professionals, patients, and other stakeholders.
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