The DOI matches its Crossref record; 46 of the 46 references it cites were found in a registry or an index.
Burnout Related to Electronic Health Record Use in Primary Care
Open accessAbstract
Physician burnout has been increasing in the United States, especially in primary care, and the use of Electronic Health Records (EHRs) is a prominent contributor. This review article summarizes findings from a PubMed literature search that shows the significant contributors to EHR-related burnout may be documentation and clerical burdens, complex usability, electronic messaging and inbox, cognitive load, and time demands. Documentation requirements have escalated and have inherently changed from paper-based records. Many clerical tasks have also shifted to become additional physician responsibilities. When considering factors of efficiency, effectiveness, and user satisfaction, EHRs overall have an inferior usability score when compared to other technologies. The volume and organization of data along with alerts and complex interfaces require a substantial cognitive load and result in cognitive fatigue. Patient interactions and work-life balances are negatively affected by the time requirements of EHR tasks during and after clinic hours. Patient portals and EHR messaging have created a separate source of patient care outside of face-to-face visits that is often unaccounted productivity and not reimbursable.
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“Cognitive load must be managed for effective problem-solving and clinical decision-making (correct decisions/reduction of errors), as levels of cognitive load influence decisions and outcomes38,49–53.”
From When better data meets better design: How EHR data usability and system usability shape physicians' cognitive load (2026) · cites this paper as [53]
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“Administrative tasks, including reviewing and responding to EHR inbox messages from patients, are often time consuming and not reimbursable, and have been linked to clinician burnout, 33 especially among female providers.”
From Wearable Devices, Health Care Use, and Psychological Well-Being in Patients With Atrial Fibrillation (2024) · cites this paper as [33]
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1 retracted
Panagioti, M., Geraghty, K., Johnson, J., Zhou, A. Y., Panagopoulou, E. P., Chew-Graham, C. A., Peters, D. H., Hodkinson, A., Riley, R. A., & Esmail, A. (2018) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2018.3713 · Cited by 1,059
RetractedShanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2015.08.023 · Cited by 2,885
Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties
Sinsky, C., Colligan, L., Li, L., Prgomet, M., Reynolds, S., Goeders, L., Westbrook, J., Tutty, M., & Blike, G. (2016) · Annals of Internal Medicine · doi:10.7326/m16-0961 · Cited by 1,494
Arndt, B. G., Beasley, J. W., Watkinson, M. D., Temte, J. L., Tuan, W.-J., Sinsky, C. A., & Gilchrist, V. J. (2017) · The Annals of Family Medicine · doi:10.1370/afm.2121 · Cited by 972
Shanafelt, T. D., West, C. P., Sinsky, C., Trockel, M., Tutty, M., Satele, D. V., Carlasare, L. E., & Dyrbye, L. N. (2019) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2018.10.023 · Cited by 914
Tawfik, D. S., Profit, J., Morgenthaler, T. I., Satele, D., Sinsky, C. A., Dyrbye, L. N., Tutty, M., West, C. P., & Shanafelt, T. D. (2018) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2018.05.014 · Cited by 756
Physician stress and burnout: the impact of health information technology
Gardner, R. L., Cooper, E., Haskell, J., Harris, D. A., Poplau, S., Kroth, P. J., & Linzer, M. (2019) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocy145 · Cited by 566
Shanafelt, T. D., West, C. P., Sinsky, C. A., Trockel, M., Tutty, M., Wang, H., Carlasare, L. E., & Dyrbye, L. N. (2022) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2021.11.021 · Cited by 456
Physician Burnout in the Electronic Health Record Era: Are We Ignoring the Real Cause?
Downing, N. L., Bates, D. W., & Longhurst, C. A. (2018) · Annals of Internal Medicine · doi:10.7326/m18-0139 · Cited by 418
Melnick, E. R., Dyrbye, L. N., Sinsky, C. A., Trockel, M., West, C. P., Nedelec, L., Tutty, M. A., & Shanafelt, T. (2020) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2019.09.024 · Cited by 413
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Cited by
Sorted by citations
Duggan, M. J., Gervase, J., Schoenbaum, A. E., Hanson, W., Howell, J. T., Sheinberg, M., & Johnson, K. B. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.60637 · Cited by 266
Shah, S. J., Devon-Sand, A., Ma, S. P., Jeong, Y., Crowell, T., Smith, M., Liang, A. S., Delahaie, C., Hsia, C., Shanafelt, T., et al. (2025) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocae295 · Cited by 224
Physician Perspectives on Ambient AI Scribes
Shah, S., Crowell, T., Jeong, Y., Devon-Sand, A., Smith, M. A., Yang, B., Ma, S. P., Liang, A. S., Delahaie, C., Hsia, C., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.1904 · Cited by 163
Wearable Devices, Health Care Use, and Psychological Well-Being in Patients With Atrial Fibrillation
Rosman, L., Lampert, R., Zhuo, S., Li, Q., Varma, N., Burg, M., Gaffey, A. E., Armbruster, T., & Gehi, A. (2024) · Journal of the American Heart Association · doi:10.1161/jaha.123.033750 · Cited by 73
“10 Anxiety and psychological stress are also highly prevalent among people with AF, affecting 25% to 45% of patients, 11–13 and are associated with greater symptom burden, higher rates of health care utilization, and worse quality of life.”
Kerr, W. T., & McFarlane, K. N. (2023) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-023-01318-7 · Cited by 60
Metadata
- Authors
- Budd, J.
- Affiliations
- University of Florida Health (US)
- Corresponding author
- Budd, Jeffrey
- ORCID
- Budd, Jeffrey
- Venue
- Journal of Primary Care & Community Health
- Publisher
- SAGE Publications
- Published
- 2023-01
- Volume
- 14
- Pages
- 21501319231166921-21501319231166921
- ISSN
- 2150-1319 (ISSN-L)
- 2150-1327
- PMC
- PMC10134123
- OpenAlex
- W4366350958
- Cited by
- 223
- References
- 46
- Citations by year
- 2026: 80 · 2025: 85 · 2024: 51 · 2023: 7
- FWCI
- 8.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Primary Care & Community Health (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Technostress in Professional Settings
- Keywords
- physician burnout, electronic health records, primary care, clinical documentation burden, clerical work, EHR usability, cognitive load, mental fatigue, patient portals, work-life balance, productivity, reimbursement
- MeSH terms
- Burnout, Professional, Documentation, Humans, Physicians, Primary Health Care, United States, Electronic Health Records
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