VA Study Shows Physicians Who Telework May Have Lower Burnout Rates and Provide Better Patient Care

During the early COVID-19 pandemic, numerous physicians were permitted to deliver telemedicine from home, but only a small percentage continue to telework. This national study within the Veterans Health Administration (VA) aimed to investigate the relationship between physician burnout and telework, as previous studies with limited sample sizes have not provided clear conclusions. 

For this survey study, data from physicians completing an annual electronic survey of all VA employees across 140 health care systems in 2020, 2021, and 2022 were analyzed (mean response rate, 69%). A dichotomized composite measure of 2 Maslach Burnout Inventory statements was used as the outcome. The physicians rated 2 statements on a scale from never to every day, indicating how frequently they felt burned out from their work and worried about their job hardening them emotionally. The exposure variables included different telework arrangements: no telework by choice, unable to telework, unapproved to telework, part-time telework, or full-time telework.  

Regression models were employed to examine the relationship between physician burnout and telework arrangements, while adjusting for survey year, physician characteristics, and composite health care system complexity. Subgroup analyses were conducted based on physician specialty and gender.  

Out of the 44,132 VA physicians who responded, primary care had the highest burnout rate at 52% followed by psychiatry at 41%. The majority of physicians, 57%, did not have telework approval, with some choosing not to telework at 12%, being unable to at 33%, and unapproved at 11%. Physicians who were unapproved for telework had a 57% higher likelihood of experiencing burnout compared to those who teleworked full-time. Primary care physicians who had greater ability to telework had lower burnout rates, with 47% for full-time, 52% for part-time, and 61% for physicians with unapproved telework. There was no association between other telework arrangements and physician burnout rates among surgeons, anesthesiologists, and emergency physicians. 

Telework has been linked to reduced burnout, increased autonomy and engagement, and decreased likelihood of voluntary quitting, indicating that flexible telework arrangements have the potential to improve job retention and ultimately enhance patient care quality. 

“To our knowledge, this study is the first to examine telework and burnout over time among US physicians. However, our survey design does not permit causal inference. We did not have information on potential confounders, like physician panel size or complexity,” said researchers. “Further study is needed to understand circumstances whereby physicians are approved or unapproved to telework and whether telework can be an effective intervention to reduce physician burnout.”  

Reference 

Leung LB, Yoo CK, Rose DE, et al. Telework arrangements and physician burnout in the veterans health administration. JAMA Netw Open. 2023;6(10):e2340144. doi:10.1001/jamanetworkopen.2023.40144