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Mitigating primary care provider burnout with interdisciplinary dyads and shared care delivery
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  • Allison Norful,
  • Yun He,
  • Adam Rosenfeld,
  • Cilgy Abraham,
  • Bernard Chang
Allison Norful
Columbia University School of Nursing
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Yun He
Columbia University Mailman School of Public Health
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Adam Rosenfeld
Columbia University Mailman School of Public Health
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Cilgy Abraham
Columbia University School of Nursing
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Bernard Chang
Columbia University Irving Medical Center
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Abstract

Rationale, aims and objectives: Increased incidence of chronic illnesses coupled with physician shortages have yielded strain on primary care providers (PCP) to meet care demands. Interdisciplinary providers such as nurse practitioners and physician assistants have increasingly been embedded into primary care teams to alleviate some workload demand. Little evidence exists about the impact of interdisciplinary PCP care delivery models on provider outcomes. The objective of this study was to investigate the impact of interdisciplinary PCP care delivery on provider burnout, job satisfaction and intention to leave current position. Methods: We conducted a cross sectional mail survey using Dillman methodology of primary care practices (e.g., internal medicine) across New York State. A random sample of interdisciplinary PCPs (physicians, nurse practitioners, and physician assistants) (n=333) responded. The Provider Co-management Index (α = .85) was used to measure how well interdisciplinary dyads co-management care delivery attributes (effective communication; mutual respect and trust; shared philosophy of care). Provider outcomes were measured with validated AHRQ and HRSA items for burnout, job satisfaction and intention to leave position. Descriptive statistics, logistic regression models, crude and adjusted odds ratios were calculated, controlling for participant and practice characteristics. Results: Almost 30% of participants reported burnout with three times the odds of intending to leave their current position within one year. With each unit increase in effective co-management between interdisciplinary dyads there was 15% less burnout and 10% less odds of intention to leave position. Conclusion: Incorporating interdisciplinary specialties in primary care appears promising to alleviate some adverse provider outcomes. Organizations contemplating delivery models to promote well-being and retention may consider co-management. Cost effectiveness research is needed to determine financial sustainability of interdisciplinary care delivery.

Peer review status:IN REVISION

29 Jul 2021Submitted to Journal of Evaluation in Clinical Practice
02 Aug 2021Assigned to Editor
02 Aug 2021Submission Checks Completed
03 Aug 2021Reviewer(s) Assigned
10 Sep 2021Review(s) Completed, Editorial Evaluation Pending
12 Sep 2021Editorial Decision: Revise Major