Adverse work conditions may be to blame for the decline in the number of primary care physicians nationwide, according to a study published in the latest issue of the Annals of Internal Medicine.

"Unfavorable work conditions are associated with stress, burnout and intent to leave," said Dr. Anita Varkey, study author and assistant professor in the department of medicine, Loyola University Chicago Stritch School of Medicine.

Because of poor job satisfaction, primary care physicians threaten to become an endangered species: The Association of American Medical Colleges estimates that the overall shortage of these doctors may grow to 124,400 by 2025, not enough to meet current needs, Varkey, who is an internist, says.

Data for this study were collected from 422 family practitioners and internists as well as 1,795 of their adult patients with diabetes, hypertension or heart failure at 119 clinics in New York and the Midwest.

Study participants were asked about perception of clinic workflow (time pressure and pace), work control, organizational culture, physician satisfaction, stress, burnout and intent to leave their practices.

More than half of the physicians, approximately 53 percent, reported time pressure during office visits, 48 percent said their work pace was chaotic, 78 percent said they did not feel in control of their daily workload and 27 percent of the doctors surveyed said they were burned out.

Some work conditions were associated with lower quality of patient care and more errors, but these findings were inconsistent.

To make sure that doctors continue to choose internal medicine--a specialty that is becoming more important than ever as the population ages--Varkey urged primary care clinicians to seize the day. They must allay physician burnout, eliminate "clinic chaos" and allow doctors to have more say over how many patients they see and for how long each day.

A healthier workplace for physicians may result in better recruitment and retention of primary care physicians, which may then translate to higher quality patient care, Varkey concluded.

Source: Loyola University Chicago Stritch School of Medicine.