Caregiving Responsibilities, Organizational Policy, and Burnout Among Primary Care Clinicians and Staff

Health care workers with responsibilities caring for dependent adults or children outside of work may be particularly vulnerable to burnout. We examined the relationship between gender, caregiving, and burnout among primary care clinicians and staff in the context of the COVID-19 pandemic.

Longitudinal cohort study using survey data collected in February 2020 and May 2021 from primary care clinicians and staff in a university-based health system. The association between gender, caregiving hours, and perceived workplace support for caregiving responsibilities on the outcome of emotional exhaustion was tested using linear models with fixed effects.

The response rate for the survey was 76% for clinicians and 90% for staff in February 2020% and 70% for clinicians and 85% for staff in March 2021. Respondents included 336 clinicians and staff, with 77% identifying as female. Female clinicians reported greater emotional exhaustion than male clinicians in 2021. Female gender, more caregiving hours, and lower workplace support were associated with higher clinician burnout. In longitudinal analysis for clinicians, hours of caregiving but not work supportiveness was associated with an increase in emotional exhaustion from 2020 to 2021. For staff, supportiveness of the workplace for caregiving responsibilities, but not gender or caregiving hours, was associated with lower exhaustion in 2021 and was protective against increased exhaustion from 2020 to 2021.

Beyond the acute stressors of the COVID-19 pandemic, ensuring the sustainability of a health care workforce that shoulders caregiving responsibility requires policies and operational models that adequately support workers with high caregiving responsibilities and work supports that encourage workers to take full advantage of the accommodations for which they are eligible.