Research Article
The Practice Of MedicineRelationship Between Physician Burnout And The Quality And Cost Of Care For Medicare Beneficiaries Is Complex
- Lawrence P. Casalino ([email protected]), Weill Cornell Medical College, New York, New York.
- Jing Li, Weill Cornell Medical College.
- Lars E. Peterson, American Board of Family Medicine, Washington, D.C., and University of Kentucky, Lexington, Kentucky.
- Diane R. Rittenhouse, Mathematica, Washington, D.C.
- Manyao Zhang, Weill Cornell Medical College.
- Eloise May O’Donnell, Weill Cornell Medical College.
- Robert L. Phillips Jr., American Board of Family Medicine.
Abstract
Despite reports of a physician burnout epidemic, there is little research on the relationship between burnout and objective measures of care outcomes and no research on the relationship between burnout and costs of care. Linking survey data from 1,064 family physicians to Medicare claims, we found no consistent statistically significant relationship between seven categories of self-reported burnout and measures of ambulatory care–sensitive admissions, ambulatory care–sensitive emergency department visits, readmissions, or costs. The coefficients for ambulatory care–sensitive admissions and readmissions for all burnout levels, compared with never being burned out, were consistently negative (fewer ambulatory care–sensitive admissions and readmissions), suggesting that, counterintuitively, physicians who report burnout may nevertheless be able to create better outcomes for their patients. Even if true, this hypothesis should not indicate that physician burnout is beneficial or that efforts to reduce physician burnout are unimportant. Our findings suggest that the relationship between burnout and outcomes is complex and requires further investigation.