Mitigating Occupational Stressors: Project Design by Family Physicians

Context: Burnout among Family Physicians (FP) has a significant personal impact (exhaustion, disengagement, and relationships) and can also lead to issues related to patient safety and access to care. Though the sources of burnout among FP are known, gaps in knowledge remain regarding solutions that may be implemented within organizations.

Objective: To explore the top two occupational stressors leading to burnout among FPs (patient expectations and administrative obligations) and to design a project in collaboration with FPs to test an intervention which will address one of these stressors and measure the impact on workplace stress.

Study Design and Analysis: Qualitative study involving focus groups and interviews with FPs using an appreciative inquiry (AI) framework. Analysis uses an iterative, grounded theory approach.

Setting: Family health organizations (FHOs) in the Kingston, Frontenac, Lennox and Addington (KFLA) region.

Population Studied: Practicing FPs recruited using an emailed invitation in conjunction with the lead physician at each FHO, as well as mailed paper invitations.

Instrument: Focus group script was developed by research team based on review of literature and consistent with the AI 4-D cycle (Discovery, Dream, Design, Destiny).

Outcome measures: Experiences of burnout; potential interventions to inform long-term solutions to workplace stress; critical elements to include in a subsequent study

Results: One focus group with 4 participants, and 4 interviews were conducted (n=8). Though FP felt their work was meaningful, burnout was common. FP agreed that unrealistic patient expectations was the most significant source of workplace stress but that an intervention to address administrative obligations was more feasible. Scribes, IT (EMR) solutions and system-level regulations were proposed interventions.

Conclusion: Burnout at work was common among FP. Though unrealistic patient expectations were identified as the top source of stress, many felt that an intervention to address this would not be successful. Next steps include developing a study to test an intervention which addresses the burden of administrative obligations in partnership with FPs.