title: "Seeing the Patient Is the Joy:" A Focus Group Analysis of Burnout in Outpatient Providers.
abstract: OBJECTIVE
  The increased demand on providers from health care systems combined with the complex and difficult practice of medicine contributes to provider stress and burnout. In order to develop effective, sustainable interventions for provider burnout, it is important to understand the lived experiences of providers and their perceptions of its causative factors. We describe focus group findings that explore provider perceptions and offer suggestions for future actions.
  
  
  METHODS
  We convened six focus groups in five clinics involving 44 participants and used a common set of questions for each group. Real-time follow-up questions varied as needed to clarify or explore specific themes. We asked for descriptions of providers' daily work, their ability to complete that work, and the frustrations associated with accomplishing their tasks. In addition, providers were asked about transparency of decision making and their perceptions of control in the workplace.
  
  
  RESULTS
  Three major themes evolved from these focus groups: the perceived impact of the work environment, work tasks, and "e-stress."
  
  
  CONCLUSIONS
  Our findings suggest three competing tensions contribute to provider burnout, none of which were attributable to patient volume or complexity. These tensions were described as originating from clinician experience of management practices and new requirements in the work environment, tension between direct patient care and non-direct patient care work tasks, and "e-stress" caused by the digital presence in providers' work lives.
authors.affiliation: Division of Applied Research, Allina Health, Minneapolis, MN.
authors.forename: William M
authors.initials: WM
authors.lastname: Spinelli
authors.forename: Karl M
authors.initials: KM
authors.lastname: Fernstrom
authors.forename: Heather
authors.initials: H
authors.lastname: Britt
authors.forename: Rebekah
authors.initials: R
authors.lastname: Pratt
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000523:psychology*; D002055:Burnout, Professional / Q000209:etiology* / Q000523:psychology*; D057286:Electronic Health Records; D005260:Female; D017144:Focus Groups; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D010465:Perception; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D017009:Professional Autonomy; D000068616:Professionalism; D013997:Time Factors; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000458:organization & administration* / Q000523:psychology