The Potential Impact of the Medical Home on Job Satisfaction in Primary Care

Comment on "Patient-Centered Medical Home Characteristics and Staff Morale in Safety Net Clinics"

When primary care physicians are satisfied with their jobs, patients benefit from improved access and quality of care.

The medical home movement—which expands primary care capabilities, and aims to produce better quality and better outcomes while lowering costs—holds the promise of also improving provider and clinic staff job satisfaction.

In this commentary, the author reviews the results of several medical home pilot studies that “have presented both hopeful and cautionary results.”

The ongoing Safety Net Medical Home Initiative found better provider job satisfaction and morale when the work environment focused on quality improvement activities and teamwork.

Another study, however, the two-year National Demonstration Project of the American Academy of Family Physicians, found change fatigue and warned that in practices transforming to medical homes, job satisfaction may worsen before improving.

In the Group Health Cooperative study, practices received significant financial support for hiring physicians, lengthening office visits and team-building interventions. A year later these practices had reduced physician and staff burnout and improved quality of care.

In order to improve job satisfaction in the medical home model, resources must be committed to transforming the culture, work processes and leadership. That also may mean accepting lowering expectations about how quickly cost savings will materialize.