Original Article

Comparison of Burnout and Fulfillment Rates between Physicians in Direct Primary Care and Other Practice Models

Authors: Melissa E. Boylan, MD, Deborah M. Hurley, PhD, MSPH

Abstract

Objectives: Primary care internal medicine and family medicine physicians experience the second and sixth highest rates of burnout among all medical specialties. Direct primary care (DPC) is an understudied model of practice in which physicians are believed to have lower rates of burnout. In this study, we surveyed primary care physicians to assess burnout and fulfillment rates as well as quantify several burnout risk factors in DPC and non-DPC practicing physicians.

Methods: The Stanford Professional Fulfillment Index was used to measure physician fulfillment and burnout in a select population of currently practicing primary care physicians in the southeastern United States. Physicians were classified by current practice model as DPC or non-DPC (self-identified). Data were analyzed to assess whether any differences existed in physician fulfillment, burnout, and other practice characteristics by medical practice/payment model.

Results: DPC physicians had significantly lower burnout (P = 0.002) and higher fulfillment scores (P = 0.013) compared with non-DPC physicians despite working a similar number of hours per week (P = 0.923). DPC physicians had a higher rate of practice ownership (P < 0.001) and saw a lower number of patients per day (P < 0.001).

Conclusions: Results show that compared with non-DPC physicians, physicians practicing the DPC model of care experience greater professional fulfillment and lower burnout. Given these significant results and the small sample size of this study, more research is warranted. A larger sample size and additional data collection would increase statistical power to better evaluate clinic and physician characteristics, allow for further exploration of the findings from this study, and increase the generalizability of results.

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