Mitigating primary care provider burnout with interdisciplinary dyads
and shared care delivery
Abstract
Rationale, aims and objectives: Increased incidence of chronic illnesses
coupled with physician shortages have yielded strain on primary care
providers (PCP) to meet care demands. Interdisciplinary providers such
as nurse practitioners and physician assistants have increasingly been
embedded into primary care teams to alleviate some workload demand.
Little evidence exists about the impact of interdisciplinary PCP care
delivery models on provider outcomes. The objective of this study was to
investigate the impact of interdisciplinary PCP care delivery on
provider burnout, job satisfaction and intention to leave current
position. Methods: We conducted a cross sectional mail survey using
Dillman methodology of primary care practices (e.g., internal medicine)
across New York State. A random sample of interdisciplinary PCPs
(physicians, nurse practitioners, and physician assistants) (n=333)
responded. The Provider Co-management Index (α = .85) was used to
measure how well interdisciplinary dyads co-management care delivery
attributes (effective communication; mutual respect and trust; shared
philosophy of care). Provider outcomes were measured with validated AHRQ
and HRSA items for burnout, job satisfaction and intention to leave
position. Descriptive statistics, logistic regression models, crude and
adjusted odds ratios were calculated, controlling for participant and
practice characteristics. Results: Almost 30% of participants reported
burnout with three times the odds of intending to leave their current
position within one year. With each unit increase in effective
co-management between interdisciplinary dyads there was 15% less
burnout and 10% less odds of intention to leave position. Conclusion:
Incorporating interdisciplinary specialties in primary care appears
promising to alleviate some adverse provider outcomes. Organizations
contemplating delivery models to promote well-being and retention may
consider co-management. Cost effectiveness research is needed to
determine financial sustainability of interdisciplinary care delivery.