Professional Dissonance and Burnout in Primary Care: A Qualitative Study
Sumit D Agarwal1,2, Erika Pabo1,2,3, Ronen Rozenblum1,2
1Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA Internal Medicine
|January 7, 2020
Summary
Primary care practitioners experience burnout due to heavy workloads and system-level issues. Addressing professional dissonance and implementing proposed solutions can improve physician well-being and patient care.
Area of Science:
- Medical Research
- Primary Care Medicine
- Occupational Health
Background:
- Physician burnout negatively impacts healthcare professionals, productivity, and patient outcomes.
- Prevalence of burnout is high among primary care practitioners (PCPs).
- Limited qualitative research exists on PCP perspectives regarding burnout.
Purpose of the Study:
- To identify factors contributing to burnout and low professional fulfillment in PCPs.
- To explore potential solutions for mitigating burnout and enhancing professional satisfaction.
- To gather insights directly from frontline PCPs on their experiences.
Main Methods:
- Qualitative study design utilizing focus group discussions and interviews.
- Conducted with 26 PCPs (physicians, nurse practitioners, physician assistants) at a US academic medical center.
- Explored factors, barriers, and solutions related to burnout, professional fulfillment, workplace culture, work-life balance, and resilience.
Main Results:
- Six common themes emerged: excessive workloads, increased administrative tasks, and unreasonable expectations.
- PCPs reported feeling demoralized, undervalued, and experiencing professional dissonance.
- Suggested solutions included workload management, institutional support, work-life balance strategies, and systemic reforms.
Conclusions:
- Frontline PCPs experience burnout stemming from value-practice dissonance, authority-responsibility mismatches, and feeling undervalued.
- Institutions can address professional dissonance and reduce burnout by implementing suggested solutions.
- Improving PCP well-being is crucial for enhancing professional fulfillment and patient care quality.
Related Concept Videos
01:08Obedience
35.1K
According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation,...
35.1K
01:27Ethical Issues
2.0K
Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:
Ethical Concerns in Healthcare:
2.0K
01:38Cognitive Dissonance
36.7K
Social psychologists have documented that feeling good about ourselves and maintaining positive self-esteem is a powerful motivator of human behavior (Tavris & Aronson, 2008). In the United States, members of the predominant culture typically think very highly of themselves and view themselves as good people who are above average on many desirable traits (Ehrlinger, Gilovich, & Ross, 2005). Often, our behavior, attitudes, and beliefs are affected when we experience a threat to our...
36.7K
02:45Self-Discrepancy Theory
18.8K
One influential perspective on what motivates people's behavior is detailed in Tory Higgin's self-discrepancy theory (Higgins, 1987). He proposed that people hold disagreeing internal representations of themselves that lead to different emotional states.
18.8K
01:29Self-Discrepancy and Its Effects
244
Self-discrepancy theory explains how people compare their actual self to their ideal and ought selves and how mismatches between these self-guides can lead to emotional distress. Developed by E. Tory Higgins, the theory distinguishes among three components of self-concept: the actual self, the ideal self, and the ought self. These refer respectively to how individuals perceive themselves, how they aspire to be, and how they believe they are obligated to be. Emotional well-being, self-esteem,...
244
01:26Methods of Documentation II: POMR
1.3K
The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.
1.3K