Working conditions in safety-net clinics deteriorate with PCMH model, survey finds

Physicians and other staff who worked in safety-net clinics adopting the patient-centered medical home model reported significant declines in satisfaction and work environment between 2013 and 2014, according to a survey conducted by Rand Corp., and published by Health Affairs.

In 2013 and 2014, Rand surveyed more than 296 federally qualified health centers participating in a CMS demonstration that required them to achieve the highest level designation of PCMH recognition within three years. Participants reported significant drops in job satisfaction over the two years surveyed (82 percent to 74 percent were satisfied), as well as increased levels of burnout (23 percent to 31 percent). Many noted an increase in chaos in the workplace (32 percent to 40 percent) and more said they were likely to the leave the job (29 percent to 38 percent).

"Things appear to have gotten worse over a short period of time at clinics that serve many of the nation's poorest and sickest patients, and we're not sure why," Mark Friedberg, MD, lead author of the study, said in a press release.

Though the study did not determine what factors led to decreased satisfaction at the FQHCs, the study's principal investigator, Katherine Kahn, MD, posited that increased use of EHRs may have had an effect on how staff perceived their jobs. "[R]apid adoption of new [EHR] systems can disrupt practice workflow and distract from face-to-face care. Also, many clinics were simultaneously trying to become a medical home while also participating in other initiatives," Dr. Kahn said in a press release.

Read more about the study here.

 

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