Family Physicians' experiences of administrative Harms

Due to the increase in corporate ownership of primary care practices, decision-making has largely shifted from physicians to administrators. Despite the increasing role of administrators in the healthcare industry, administrative harms are largely under-researched. This article explores employed or previously employed physicians' experiences of administrative harms.

In-depth, semi-structured interviews were conducted via Zoom in January 2025 by a trained qualitative researcher. Interviews with 27 American Board of Family Medicine (ABFM) diplomates who completed a continuing certification questionnaire in 2024 lasted an average of 63 minutes. Inductive content analysis guided the development of codes and themes.

Most participants (55.5%) self-identified as women, lived in the Western US Census Region (33.3%), worked for a hospital or hospital-owned practice, and self-identified as white (48.1%). The average interview participant age was 48.6 years. Three broad types of administrative harms were identified: physician input was dismissed or devalued; physician time and activity were strictly structured; administrative decisions created a workplace environment that did not support basic biological needs.

In this qualitative study, family physicians described experiences of administrative harms that contributed to burnout, turnover, and compromised self-care that led to perceived lower quality patient care. Continued research about administrative harms is crucial given the projected growth in administrative positions compared to clinical positions. Changes to payment policies and upstream corporate policies that prioritize profits over patients could alleviate physician frustration and administrative burdens.