Association of clerical burden and EHR frustration with burnout and career intentions among physician faculty in an urban academic health system

Background and objectives

To examine changes in clerical burden, including daily clerical time, daily after hours Electronic Health Record (EHR) time and EHR frustration between 2018 and 2022 among physician faculty, and identify sociodemographic and occupational correlates of clerical burden with burnout and intent to leave one’s job (ILJ).

Methods

An institution-wide survey was sent to all physician faculty at an 8-Hospital Health System in New York City, between July and September 2022. Clerical time, after hours EHR time, practice unloading clerical burden and EHR frustration were assessed using ordinal-scale questions. Burnout was assessed using the Maslach Burnout Inventory-2. Demographic characteristics and ILJ were also assessed. Multivariable logistic regression analyses were conducted to determine associations between clerical burden and burnout and ILJ.

Results

Daily clerical and after hours EHR time increased in 2022 compared with 2018–2019 data. Medicine- vs. hospital-based department and hours worked per week were associated with greater clerical and after hours EHR time, and female gender with greater after hours EHR time. After adjusting for demographic and occupational characteristics, greater clerical time and EHR frustration were associated with greater likelihood of burnout. Endorsement of practice efforts unloading burden was associated with lower odds of burnout. EHR frustration was associated with greater likelihood of ILJ. Junior faculty rank was linked to both burnout and ILJ.

Conclusions

Clerical burden may be increasing among physician faculty and may be linked to greater odds of burnout and intention to leave. Results underscore the importance of unloading this burden to maintain a healthy workforce and avoid strain on our healthcare system.