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Relationship Between Clerical Burden and Characteristics of the Electronic Environment With Physician Burnout and Professional Satisfaction



      To evaluate associations between the electronic environment, clerical burden, and burnout in US physicians.

      Participants and Methods

      Physicians across all specialties in the United States were surveyed between August and October 2014. Physicians provided information regarding use of electronic health records (EHRs), computerized physician order entry (CPOE), and electronic patient portals. Burnout was measured using validated metrics.


      Of 6375 responding physicians in active practice, 5389 (84.5%) reported that they used EHRs. Of 5892 physicians who indicated that CPOE was relevant to their specialty, 4858 (82.5%) reported using CPOE. Physicians who used EHRs and CPOE had lower satisfaction with the amount of time spent on clerical tasks and higher rates of burnout on univariate analysis. On multivariable analysis, physicians who used EHRs (odds ratio [OR]=0.67; 95% CI, 0.57-0.79; P<.001) or CPOE (OR=0.72; 95% CI, 0.62-0.84; P<.001) were less likely to be satisfied with the amount of time spent on clerical tasks after adjusting for age, sex, specialty, practice setting, and hours worked per week. Use of CPOE was also associated with a higher risk of burnout after adjusting for these same factors (OR=1.29; 95% CI, 1.12-1.48; P<.001). Use of EHRs was not associated with burnout in adjusted models controlling for CPOE and other factors.


      In this large national study, physicians' satisfaction with their EHRs and CPOE was generally low. Physicians who used EHRs and CPOE were less satisfied with the amount of time spent on clerical tasks and were at higher risk for professional burnout.

      Abbreviations and Acronyms:

      CPOE (computerized physician order entry), EHR (electronic health record), GIM (general internal medicine), IM (internal medicine), OBGYN (obstetrics/gynecology), OR (odds ratio), PM&R (physical medicine and rehabilitation)
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      Linked Article

      • MACRA Regulatory Burdens and the Threat of Physician Burnout
        Mayo Clinic ProceedingsVol. 91Issue 11
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          The research article by Shanafelt et al1 regarding clerical burden and physician burnout is timely and provides much needed objective data in this arena. No doubt, for most physicians, the current electronic environment has greatly increased the clerical burden of physicians without necessarily enhancing the quality of medical care or workflow efficiency. This burden will be especially heavy for small practices that lack the administrative resources found in large health care organizations.
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