Reducing family physician burnout starts with EHRs and nurse-physician teams

Family physicians across the U.S. are experiencing high burnout rates, a growing issue that impacts both their well-being and the quality of patient care. A recent study published in JAMA Network Open has identified two key contributors to this burnout: excessive time spent on electronic health records (EHRs) outside of work hours and inadequate collaboration with nursing staff.

Focusing on reducing EHR burdens and fostering stronger nurse-physician relationships, the study suggests, can significantly improve job satisfaction and decrease burnout in family medicine. The study, which surveyed over 10,000 doctors, found that physicians who spent a significant amount of time on EHR tasks after hours were at a higher risk of burnout.

Interestingly, while EHRs are often cited as a technological burden, proficiency with these systems was not found to be a factor in burnout. Instead, burnout seems more tied to how EHRs are managed within the team dynamic.

Many doctors reported that collaboration with registered nurses (RNs) improved team efficiency, while collaboration with physician assistants was associated with better use of EHR time. However, substituting medical assistants for RNs on core teams was linked to increased physician workload and decreased team efficiency, underscoring the value of maintaining a skilled nursing presence.

Why this matters

Physician burnout is a state of physical, emotional, and mental exhaustion experienced by doctors due to chronic workplace stress and demanding job conditions. But it is more than just a personal issue; it has far-reaching implications for healthcare quality and patient outcomes. When family physicians are overburdened with administrative tasks, particularly electronic health records (EHR) outside of work hours, their ability to provide focused, compassionate care can suffer.

Burnout affects mental health, leading to stress, fatigue, and even a desire to leave the profession entirely. This not only impacts the well-being of physicians but also reduces patient satisfaction, creates inefficiencies, and strains the healthcare system. Addressing burnout is essential to maintaining a resilient healthcare workforce and ensuring patients receive attentive, effective care.

Strengthening nurse-physician collaboration and optimizing EHR workflows offer viable solutions. A collaborative environment, where registered nurses and physician assistants can take on more responsibility, enables doctors to concentrate on their primary duties and reduces the need for after-hours work.

Similarly, minimizing the EHR workload during non-clinical hours helps create a healthier work-life balance, improving job satisfaction and decreasing turnover. With a more sustainable approach, healthcare practices can enhance team efficiency and support the longevity and well-being of their medical staff.

How nurse-physician collaboration reduces burnout

Effective nurse-physician collaboration is a crucial factor in promoting team efficiency, according to the study. A well-coordinated team structure, where registered nurses can take on responsibilities like administering flu vaccines and performing routine procedures, can lighten the load on physicians.

I used to be able to finish a progress note in less than 5 minutes.

Sonia Rivera-Martinez, DO, associate professor of family medicine at NYITCOM

Dr. Rivera-Martinez, a family physician and one of the study participants, noted that this approach has greatly improved workflow in her practice. By allowing her two nurses to operate independently on certain tasks, she is able to focus more on her core responsibilities, reducing the need for extensive after-hours work.

Enhanced teamwork does more than alleviate workload; it fosters a supportive environment, which can improve morale and reduce stress. The study found that strong nurse-physician relationships correlate with lower burnout levels, likely because they foster a sense of shared responsibility and reduce isolation. These findings emphasize the need for practices to assess and strengthen team dynamics as a strategy for preventing burnout.

The impact of EHRs on work-life balance

The increased demand of electronic health records on family physicians is another major factor in burnout. According to the study, doctors who viewed after-hours EHR work as acceptable were more likely to experience burnout, indicating that boundaries between work and personal time are essential for maintaining well-being. Dr. Rivera-Martinez shared that she dedicates an additional 20–30 hours weekly to completing EHR tasks, a workload that is unsustainable for many in the profession.

EHRs are integral to modern healthcare, but they need to be managed more effectively to support physicians’ mental health. Some respondents highlighted the potential of ambient documentation technology—software that records and summarizes physician-patient conversations without unnecessary details—as a promising solution.

AI-driven tools can also assist by automating visit summaries and patient instructions, reducing the time physicians spend on administrative tasks. However, cost remains a barrier; many of these technologies are expensive, making them inaccessible to smaller practices.

The value of targeted technological upgrades

While AI solutions and advanced documentation tools could help streamline clinical workflows and lessen EHR burdens, affordability is a significant obstacle. Dr. Waldren, another study contributor, pointed out that these upgrades could be transformative if they were made more accessible.

High costs currently prevent many practices from adopting these solutions, particularly in smaller or independent practices that may lack funding. For widespread impact, there is a clear need for affordable, scalable technologies that support efficiency without adding financial strain.

Even if you can just focus on documentation and improve that, it gives docs hope that other things can happen and actually improve. We saw a decrease in burnout in just solving that one problem.

Steven Waldren, an associate professor of family medicine at NYITCOM

Beyond technology, the study’s findings emphasize that physician burnout isn’t solely a matter of individual workload but also an issue of systemic inefficiencies. A more comprehensive approach that considers both workflow improvements and team collaboration will likely yield the best results. This broader perspective on burnout solutions could make the healthcare system more sustainable for physicians and improve patient care quality.

Rethinking healthcare team structures

The study reveals an emerging trend of substituting registered nurses with medical assistants in core clinical teams, a shift that has increased the workload for family physicians and negatively impacted team efficiency. While medical assistants play an essential role, replacing RNs with less specialized team members may lead to gaps in patient care and increase the demands on doctors.

For family physicians to thrive, it’s critical to have a well-structured team with the right balance of skills and support. Ensuring that core clinical teams have adequate RN staffing could be key to preventing burnout and optimizing efficiency.

Future strategies could benefit from focusing on both technological upgrades and team structure improvements. This combination of solutions addresses both the digital demands of healthcare and the human connections essential to a successful practice. By prioritizing skilled, collaborative teams, family practices can better manage patient care while promoting a healthier, more balanced work environment for physicians.

An integrated approach

Family physician burnout is a multifaceted issue that requires a multi-pronged solution. As the study suggests, decreasing EHR demands and fostering nurse-physician collaboration are two powerful strategies for creating a sustainable work environment. When physicians have the support of skilled nursing staff and clear boundaries around administrative tasks, they are better positioned to avoid burnout and focus on the rewarding aspects of patient care.

These findings underscore the need for healthcare policies and practices that prioritize physicians’ mental health by addressing systemic pressures and supporting team efficiency. Reducing family physician burnout will require a commitment from both healthcare providers and policymakers to ensure that doctors have the tools, team structure, and time they need to thrive in their roles. A comprehensive approach, integrating both team-based and technological solutions, offers the most promising path toward a resilient healthcare workforce.