Assessing Loneliness and Other Types of Emotional Distress among Practicing Physicians

Introduction. Loneliness has been linked to clinician burnout and other types of emotional distress. Research assessing the prevalence of loneliness among physicians is growing. Little is known, however, about how loneliness relates to other types of emotional distress among practicing physicians. The objectives of the study were to determine the prevalence of loneliness, and to explore the relationship between loneliness, burnout, depressive symptoms, and suicidal ideation among active member physicians of the Medical Society of Sedgwick County (MSSC). Methods. The study involved a convenience sample of 197 practicing physicians who were active members of the MSSC. The 3-item University of California, Los Angeles Loneliness Scale, the Abbreviated Maslach Burnout Inventory, and 2-item Primary Care Evaluation of Mental Disorders Patient Health Questionnaire were used to measure prevalence of loneliness, manifestations of burnout, and symptoms of depression, respectively. Results. Using an email survey, 442 practicing physicians received an invitation to participate; 197 (44%) completed the survey. The prevalence of loneliness was 43%. Loneliness prevalence was associated positively with age (p = 0.017) and more likely in those who reported manifestations of burnout (p < 0.01) or screened positive for depression (p < 0.01). Depression (OR = 2.24; 95% CI, 0.97-5.19) and emotional exhaustion (OR = 1.05; 95% CI, 0.39-2.84) were significantly associated with loneliness, including when adjusted for participants’ sex, age, and duty hours. Conclusion. Loneliness is prevalent among active member physicians of the Medical Society of Sedgwick County. Given that loneliness is associated with burnout and other emotional distress, there is an important need to understand its implications better

The Influence of Loan Repayment and Scholarship Programs on Healthcare Provider Retention in Underserved Kansas

Background. In an effort to redistribute healthcare providersto underserved areas, many states have turned to financialincentive programs. Despite substantial research on theseprograms on a national scale, little is known about the successof such programs in Kansas. The purpose of this studywas to provide insight into the relationship between financial incentive programs and provider retention in Kansas. Methods. A cross-sectional telephone survey was conducted inApril and May of 2011 with participants who had completedtheir obligations to the Kansas State Loan Repayment Program(SLRP), the National Health Service Corps (NHSC) Loan Repaymentprogram, or the National Health Service Corps Scholar shipprogram in Kansas between January 2006 and January 2011. Results. Of the 112 providers included in the study, 54.4% (n = 61)had left their program sites sometime after finishing their commitment,with the mean length of stay after the obligation periodended being 7.3 (median = 3) months. Of the 54 participants whohad left their program sites and whose current locations wereknown, 33.3% (n = 18) were located in new Health ProfessionalShortage Areas (HPSA), 25.9% (n = 14) were in a new non-HPSA,and 40.7% (n = 22) had left the state. Family satisfaction with thecommunity and attending a professional school in Kansas wereassociated statistically with retention of physicians in Kansas. Conclusions. Nearly half of all participants had remained attheir sites even after their obligation period ended, with familysatisfaction with the community appearing to be the strongestpredictor for retention among those who had stayed.Efforts to match a provider’s family with the community successfullyand to support the family through networking mayimprove future provider retention. KS J Med 2016;9(1):6-11

Burnout and Quality of Life among Active Member Physicians of the Medical Society of Sedgwick County

Introduction. The medical literature suggests disturbingly high ratesof burnout among US physicians. The objective of this study was todetermine the rates of burnout, other forms of distress, and overallquality of life among physicians in Sedgwick County.Methods.xThe study involved a convenience sample of 197 physicianswho were active member physicians of the Medical Society of SedgwickCounty (MSSC). Between July and August 2018, we surveyed872 physicians who were active members of the MSSC. The surveyassessed manifestations of burnout, symptoms of depression and suicidalideation, fatigue, and quality of life. The authors used standarddescriptive summary statistics, Mann-Whitney U test/independentsamples t-Test, Fisher’s exact test, and correlations to analyze thedata.Results. The participation rate was 44.6%, with 49.5% of therespondents reporting manifestations of burnout. Although 85% ofthe participants rated their overall quality of life as good/very good,45% screened positive for depression, 5% had thoughts of suicideduring the past year, and 44% reported excessive fatigue during thepast week. Those with manifestations of burnout were 2.13 (100%vs 46.9%, p < 0.01) times more likely to report thoughts of suicidalideation, 2.43 (72.6% vs 30.4%; p < 0.001) times more likely to screenpositive for depression, and 1.89 (67.5% vs 35.8%; p < 0.001) timesmore likely to have high degrees of fatigue. All of the participants whohad suicidal ideation reported manifestations of burnout.Conclusions. Burnout was prevalent among active member physiciansof the MSSC. Burnout among the participants was associatedwith symptoms of depression, fatigue, suicidal ideation, and intentionof leaving the medical profession via early retirement and/or careerchange. Kans J Med 2019;12(2):33-39

Why Patients Miss Scheduled Outpatient Appointments at Urban Academic Residency Clinics: A Qualitative Evaluation

Introduction Missed outpatient appointments are a common problem for academic residency clinics, and reducing their rate improves office efficiency, income, and resident education. Identifying specific reasons why some patients miss outpatient appointments may provide insight into developing targeted approaches to reducing their rates. This study sought to find reasons associated with patients’ missed appointments at two family medicine residency clinics. Methods The study utilized a qualitative research design involving patients at two urban, university-affiliated family medicine residency outpatient clinics. Twenty-five randomly selected patients who were dismissed from the clinics for missing three or more scheduled appointments during a five-year span (July 2012 to July 2017) were interviewed over the phone about reasons they did not keep their scheduled clinic appointments. The authors, individually and as a group, used an immersion-crystalization approach to analyze the content of the interviews. Results Responses from 25 participants (21 females and four males) are presented. Fifty-two percent of patients were Caucasian, 32% Black, 12% Hispanic, and 4% Asian. Five themes emerged from the data analysis as major reasons the patients missed their scheduled outpatient appointments: forgetfulness, transportation issues, personal health issues, family and employer obligations, and other issues, such as anticipated long clinic wait times, bad weather, and financial problems. Conclusions The findings showed there are several logistical, situational, and clinical reasons for patients’ missed scheduled outpatient appointments

Successes and Challenges of Optimal Trauma Care for Rural Family Physicians in Kansas

Introduction. Kansas has a regionalized trauma systemwith formal mechanisms for review, however, increasedcommunication with rural providers can uncover opportunitiesfor system process improvement. Therefore, thisqualitative study explored perceptions of family medicinephysicians staffing emergency departments (ED) in rural areas,specifically to determine what is going well and what areasneeded improvement in relation to the trauma system. Methods. A focus group included Kansas rural family physiciansrecruited from a local symposium for family medicinephysicians. Demographic information was collected via surveyprior to the focus group session, which was audiotaped.Research team members read the transcription, identifiedthemes, and grouped the findings into categories for analysis. Results. Seven rural family medicine physicians participated inthe focus group. The majority were male (71%) with the mean age46.71 years. All saw patients in the ED and had treated injuriesdue to agriculture, falls, and motor vehicle collisions. Participantsidentified successes in the adoption and enforcement of standardizedprocesses, specifically through level IV trauma centercertification and staff requirements for Advanced Trauma LifeSupport training. Communication breakdown during patient dischargeand skill maintenance were the most prevalent challenges. Conclusions. Even with an established regionalized traumasystem in the state of Kansas, there continues to be opportunitiesfor improvement. The challenges acknowledged byfocus group participants may not be identified through patientcase reviews (if conducted), therefore tertiary centersshould conduct system reviews with referring hospitals regularlyto improve systemic concerns. KS J Med 2017;10(1):12-16

Assessing Work-Related Burnout and Job Satisfaction among Obstetrics and Gynecology Residency Program Coordinators

Introduction. This study explored the prevalence of and the relationshipbetween job satisfaction and burnout among obstetrics andgynecology residency program coordinators.Methods.xThis cross-sectional study involved members of theAmerican Program Managers of Obstetrics and Gynecology. TheCopenhagen Burnout Inventory and Spector’s Job SatisfactionSurvey were used to measure the participants’ burnout and job satisfactionrates respectively. Data were collected between August 2017and December 2017. The authors used Fisher’s exact tests, Spearman’sr correlations, and multiple linear regression to analyze thedata.Results. There was an 83% (171/207) response rate. Thirteenpercent of the coordinators reported high, 70% moderate, and 17%low job satisfaction scores. Thirty-nine percent of the coordinatorsreported high, 25% moderate, and 36% slight work-related burnoutrates. Correlation coefficient showed a significantly negative relationshipbetween job satisfaction and work-rated burnout, (rs[169] =-0.402, p < 0.01). Regression analysis showed co-workers (β = -0.47)and supervision (β = -0.16) domains of the job satisfaction scale weresignificant predictors of work-related burnout (R = 0.55; F[5, 195] =11.05; p < .001).Conclusions. The findings highlight the importance of job satisfactionfactors, such as support from coworkers and supervisors, indealing with work-related burnout among residency coordinators.Kans J Med 2019;12(1):11-16

A Qualitative Assessment of Kansas Tracking and Reporting of Controlled Substances (K-TRACS)

Introduction. This study assessed the Kansas Tracking and Reporting of Controlled Substances system (K-TRACS), the online controlled prescription medication monitoring website in Kansas. The specific aims were to determine if and when pharmacists and physicians in Kansas were using K-TRACS and to identify any perceived benefits or barriers to using K-TRACS. Methods. A non-randomized, convenience sample of Kansas pharmacists and family physicians were interviewed face to face using a guided semi-structured questionnaire. NVivo 10 (QSR International Pty Ltd.) was used to analyze data. Results. Ten physicians and sixteen pharmacists were interviewed. All pharmacists and 70% of physicians were using K-TRACS. Usage was prompted by encounters with new patients or unease with the patient interaction. The perceived benefits included increased communication with the patient and all providers, increased provider comfort with treating chronic pain, and altered prescriber habits. Barriers to the use of K-TRACS were identified as login, password, and operating system problems. Conclusions. Among study participants, K-TRACS is used regularly, is perceived to be a benefit to providers, patients and communities, and has become a useful new tool in the treatment of chronic pain. K-TRACS is perceived to facilitate increased communication between providers and with patients