Patient reciprocity and physician burnout: what do patients bring to the patient-physician relationship?

Despite its criticality to the provision of health care, little is known about how the patient-physician relationship influences burnout. This article seeks to understand how patient performance (e.g. being informative about needs) during office visits is associated with perceived reciprocity in the patient-physician relationship, which is in turn associated with physician burnout. To that end, we report the results of a cross-sectional survey of 252 matched pairs of patients and their primary care physicians about a recent office visit. The findings support a social exchange model of burnout that suggests that patient stressors and patient performance predict perceived reciprocity and subsequent burnout. Interestingly, patients' perceptions of their performance differed from physicians' perceptions; physicians' perceptions of performance fit the social exchange model better than patients' perceptions of performance.The present work suggests that while they are a source of demands, patients also provide resources that are critical to the patient-physician relationship. To the extent that we can encourage these resources, we can improve perceived reciprocity and reduce burnout in physicians.