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Editor's Correspondence
April 22, 2013

Declining Proportion of Physician-Owned Practices Possibly Related to Increasing Burnout

Author Affiliations

Author Affiliations: Scott Department of Urology, Baylor College of Medicine, Houston, Texas (Dr Joshi); and Department of Clinical Medical Education, University of Miami Miller School of Medicine, Miami, Florida (Mr Nehaul and Dr Broome).

JAMA Intern Med. 2013;173(8):710. doi:10.1001/jamainternmed.2013.3290

In their article “Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population,” Shanafelt et al do an excellent job identifying increased rates of burnout among physicians, especially those in primary care.1 Their findings deserve immediate action to address the underlying causes.

Shanafelt et al1 mentioned several possible contributors, but others also deserve mention. Unmistakably, health care has undergone a lot of changes within the past couple decades, including the precipitous decline of physician-owned practices. In 2009, an article in the New England Journal of Medicine estimated that the number of physicians who own their own practice has been declining at a rate of 2% annually for the past 25 years.2 This trend is not insignificant and may be related to the findings by Shanafelt et al.1 The same drivers affecting physician ownership of practices may also be at play in physician burnout and satisfaction with work-life balance.

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