In one of the most non-stories we have ever published, it was discovered that:

Primary care practices with zero burnout are more often solo practices owned by physicians and practices not involved in transformation initiatives, such as accountable care organizations (ACOs), according to an analysis published today in Health Affairs.

This study did not say if DPC practices were surveyed but most likely not because their definition of workload included such as seeing a large amount of patients and dealing with insurance companies.

It was also surprising, Edwards said, that practices with some of the heaviest workloads ― solo practitioners juggling large numbers of patients, insurance plans, and regulatory requirements ― were much more likely than larger practices to report zero burnout.

Imagine if they did study DPC? The study author may have had a heart attack because he seems so excited with the results he got already.

Here are some take home points from the Medscape article:

• He says in small offices, there may be a stronger sense of agency, a sense that everyone is on the same team, and there may be stronger relationships with patients.
• Organizations that participated in ACOs and other external primary care transformation projects were more likely to have high burnout rates.
• By contrast, burnout may be higher in health system–owned practices because clinicians may feel they have less control over their work environment and feel a loss of autonomy, according to Goldberg.
• At the same time, “Having agency at the practice level about how things work is really important in reducing burnout. So in a large system, finding ways to promote agency at the most local level possible can really help with burnout,” he said.

You are going to see that word agency a lot. It means ownership and skin in the game. It means not working for the man. It means a feeling of control over your destiny.

I would expect the big hospital employers, the large medical corporations that keep proliferating, and all medical administrators associated with these groups to try to and hijack that word. Don’t let them.

AGENCY = DIRECT PRIMARY CARE = NO BURNOUT