Physical work environment and burnout among primary care physicians in Israel: a cross-sectional study

Yaara Bentolila, Liat Lev Shalem, Bar Cohen, Miri Mizrahi Reuveni, Arnon Shahar, Limor Adler

Keywords: burnout, prevention, work environment, primary care

Background:

Physicians' burnout is extensive and affects work satisfaction and patient care. Studies regarding physical work environments of physicians and their impact on burnout are scarce. The physical work environment is everything that surrounds the physician, including the doctor's office, the clinic, the clinic building, the waiting, and staff rooms.

Research questions:

To describe aspects of the physical work environment of primary care physicians (PCPs) and to explore the association between physical work environment and burnout.

Method:

In this cross-sectional study, we sent online questionnaires to PCPs in Israel during October 2021. We asked physicians about their satisfaction with their physical work environment, evaluated elements of the work environment, and assessed burnout status (with the Shirom-Melamed Burnout Measure, SMBM). We used the chi-square test and the Mann-Witney test to compare categorical and continuous variables and used a logistic regression for the final model.

Results:

221 PCPs answered the questionnaire (27.6% response rate). Over a third (35.7%) of respondents reported high burnout. PCPs who were satisfied with their general physical environment had lower rates of burnout (28.1% vs. 47.8%, p-value<.001). We found positive correlations between general satisfaction with the physical work environment and the scores achieved for the doctor's office, the clinic, the clinic's building, and the waiting room. In the multivariate analysis, age and gender did not impact burnout rates.

Conclusions:

We suggest certain elements of the physical work environment indirectly affect burnout rates, with general satisfaction from physical work environment being a moderating variable through which this influence is manifested.

Points for discussion:

In this study, we report a rate of burnout (SMBM>4) of 37.5% among respondents.

PCPs who were satisfied or highly satisfied with their general physical work environment had a lower prevalence of burnout.

We found a positive correlation between general satisfaction from the physical work environment and factors related to the clinic's building, the clinic, the doctor's office, and the waiting room.