Daniel Tawfik, MD, MS Pediatric Critical Care Medicine Stanford University School of Medicine

How Much Does Physician Burnout Affect Quality of Health Care?

MedicalResearch.com Interview with:

Daniel Tawfik, MD, MS Pediatric Critical Care Medicine Stanford University School of Medicine

Dr. Tawfik

Daniel Tawfik, MD, MS
Pediatric Critical Care Medicine
Stanford University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Professional burnout is very common among health care providers and is frequently associated with poor quality of care in the published literature. However, we know that reporting biases are common in many fields of literature, and these biases typically result in exaggerated effects being published relative to the true effect. Research on burnout and quality of care appears especially vulnerable, because many studies are not pre-specified or have several potential methods of analysis. If the studies or analyses with more impressive results are more likely to be published, this would result in a skewed picture of the relationship between burnout and quality of care.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this study, we found 123 publications that report on the relationship between health care provider burnout and quality of care. Although the overwhelming majority of the results indicated that burnout associates with poor quality of care, we did find a higher number of statistically significant results than would be expected based on the most reliable studies. This suggests that some of the published studies may report stronger relationships than is accurate, and/or that there have been some studies that were not published because they showed no association. 

MedicalResearch.com: What should readers take away from your report?

Response: Health care provider burnout associates with poor quality of care among a wide variety of quality measures. Although the overall relationship appears to be moderately strong, the published literature may overestimate the strength of the relationship.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Future research on the relationship between burnout and quality of care should attempt to reduce the risk of bias as much as possible, by registering studies before they are done (to reduce the risk of publication bias), pre-specifying how analyses will be done and reported (to reduce the risk of selective reporting biases), and by using established approaches to defining burnout and measuring quality of care (to improve comparability among studies). In addition, longitudinal studies will be important to evaluate the timing and direction of the relationships between burnout and quality of care. When researchers are designing prospective studies, they should recognize that the effects they observe in the study may be smaller than what would be predicted from the published literature, meaning they may need larger sample sizes or a longer period of data collection to have an adequately-powered study. 

MedicalResearch.com: Is there anything else you would like to add?

 

Response: We have no relevant conflicts of interest. This study was supported by research grants from the Stanford Maternal and Child Health Research Institute and from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Citation: 

Evidence Relating Health Care Provider Burnout and Quality of CareA Systematic Review and Meta-analysis

Ann Intern Med. 2019. DOI: 10.7326/M19-1152

 

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Oct 8, 2019 @ 5:29 pm

 

 

 

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