Date of Graduation

Summer 8-9-2014

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

Abstract

Background: This promise of a patient centered medical home (PCMH) is being embraced by many, in hopes that it will improve healthcare in the United States by decreasing costs and improving patient outcomes. However, as important as cost and patient outcomes are, another integral part of the PCMH equation isn’t discussed very often: the providers. How will PCMHs impact providers? This systematic review of literature will investigate the use of PCMHs and its affect on the satisfaction and burnout of providers.

Methods: An exhaustive search of current medical literature was performed on Medline-OVID, EBMR-Cochrane Review, and CINAHL, using the keyword patient-centered medical home and the MESH terms patient centered care, job satisfaction, and burnout, professional. The references of relevant articles were screened for additional studies.

Results: Two articles were found to satisfy inclusion criteria. Lewis et al was an observational retrospective cohort study which used a self-administered survey in 2010 to assess staff morale, job satisfaction, burnout, and respondents’ perceptions of PCMH characteristics at 65 safety net clinics in five states. Lewis et al found that the total PCMH score was associated with higher staff morale but that the providers had less freedom from burnout as the PCMH score increased. Reid et al used a prospective, two group before and after evaluation of the PCMH pilot at Group Health, located in western Washington. Researchers compared the staff and providers at the PCMH clinic with the staff and providers at two other non-PCMH clinics. At 24-months the mean emotional exhaustion scores for the PCMH was significantly lower than the control clinics.

Conclusion: Research on this topic is of low quality and is very limited with only one study assessing provider satisfaction and two studies assessing provider burnout. Though it may appear that PCMH may decrease provider burnout, conflict in the research does exist. More research is needed as PCMHs become an industry standard in the coming years.

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