The study sampled 487 adults aged 18 and older from across the United States, recruited through CloudResearch and surveyed via the Qualtrics platform. The sample was fairly balanced in gender, with 48.0% identifying as female and 51.5% as male. In terms of age distribution, 42.5% were young adults, 39.8% were middle-aged, and 17.7% were older adults. Educational attainment varied, with 14.4% having a high school education or less, 69.9% holding a college degree, and 15.7% possessing a graduate degree. Politically, half of the participants (50.1%) identified as liberal, while 34.7% were conservative and 15.2% moderate. Participants were randomly assigned to one of two vignette conditions: 51.1% to the treatment group (physician with burnout symptoms) and 48.9% to the control group (physician without burnout symptoms). This diverse and representative sample allowed for a robust evaluation of how physician burnout influences perceptions of care quality, safety, and satisfaction.
This study examines how physician burnout affects public perceptions of care quality, safety, and satisfaction, and whether political ideology moderates these effects. Using a vignette-based experiment with 487 U.S. adults, participants were randomly assigned to evaluate a physician exhibiting burnout or non-burnout behaviors. Adjusted ordinal logistic regression revealed extreme effects as individuals perceived non-burnout physicians as having 85 times higher odds of excellent quality ratings (aOR=85.35, 95% CI[47.12,154.63]), 29 times higher odds of safety perceptions (aOR=28.89, 95% CI[16.49,50.62]), and 69 times higher odds of maximum satisfaction (aOR=68.63, 95% CI[36.81,127.96]) (*p*<0.001). Communication quality partially mitigated burnout’s impact (Safety: aOR=1.59; Quality: aOR=1.39; Satisfaction: aOR=1.43, *p*<0.01), while demographics showed no significant effects.
Notably, the interaction between political ideology and burnout moderated satisfaction ratings (*p*<0.05), with conservatives exhibiting weaker dissatisfaction responses (aOR=0.39) than liberals, aligning with Moral Foundations Theory. This suggests that moral values (e.g., authority vs. care priorities) shape tolerance for burnout-related behaviors. The findings highlight burnout’s universal negative influence on people's perceptions, while revealing ideological divides in satisfaction ratings.
Policy implications include structural reforms (e.g., EHR optimization, reduced administrative burden to improve physician well-being, and patient perceptions of care quality. Standardized communication training programs should focus on active listening and empathy. Limitations include cross-sectional design and vignette-based methods. Future research should explore mechanisms linking burnout to perceptions and test interventions targeting provider well-being and patient-provider dynamics.
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