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Burnout and Health Care Workforce Turnover
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PURPOSE: Levels of burnout among primary care clinicians and staff are alarmingly high, and there is widespread belief that burnout and lack of employee engagement contribute to high turnover of the workforce. Scant research evidence exists to support this assertion, however. METHODS: We conducted a longitudinal cohort study using survey data on burnout and employee engagement collected in 2013 and 2014 from 740 primary care clinicians and staff in 2 San Francisco health systems, matched to employment roster data from 2016. RESULTS: Prevalence of burnout, low engagement, and turnover were high, with 53% of both clinicians and staff reporting burnout, only 32% of clinicians and 35% of staff reporting high engagement, and 30% of clinicians and 41% of staff no longer working in primary care in the same system 2 to 3 years later. Burnout predicted clinician turnover (adjusted odds ratio = 1.57; 95% CI, 1.02-2.40); there was also a strong trend whereby low engagement predicted clinician turnover (adjusted odds ratio with high engagement = 0.58; 95% CI, 0.33-1.04). Neither measure significantly predicted turnover for staff. CONCLUSIONS: High rates of burnout and turnover in primary care are compelling problems. Our findings provide evidence that burnout contributes to turnover among primary care clinicians, but not among staff. Although reducing clinician burnout may help to decrease rates of turnover, health care organizations and policymakers concerned about employee turnover in primary care need to understand the multifactorial causes of turnover to develop effective retention strategies for clinicians and staff.
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“The preliminary study had a 12-month turnover rate of 16% between the 2017 and 2018 surveys, consistent with estimates for the healthcare industry [34].”
From The Work-life Check-ins randomized controlled trial: a leader-based adaptive, semi-structured burnout intervention in primary care clinics (2024) · cites this paper as [34]
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Metadata
- Authors
- Willard-Grace, R., Knox, M., Huang, B., Hammer, H., Kivlahan, C., & Grumbach, K.
- Affiliations
- University of California, San Francisco (US)
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2019-01
- Volume
- 17
- Issue
- 1
- Pages
- 36-41
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC6342603
- OpenAlex
- W2911242397
- Cited by
- 400
- References
- 27
- Citations by year
- 2026: 54 · 2025: 56 · 2024: 62 · 2023: 87 · 2022: 60 · 2021: 48 · 2020: 22 · 2019: 10
- FWCI
- 47.72
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
- Keywords
- burnout, employee engagement, primary care providers, primary care staff, clinician retention
- MeSH terms
- Burnout, Professional, Humans, Personnel Turnover, Primary Health Care, San Francisco, Prevalence, Physicians, Primary Care
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