Author Credentials

Dr. Kevin McCann Department of Family and Community Health Joan C. Edwards School of Medicine Marshall University Dr. Adam Baus School of Public Health West Virginia University Dr. Joanna Bailey Laura Boone Jennifer Boyd Dr. Martha Cook-Carter Dr. Dan Doyle

Author ORCID Identifier

Kevin Mccann: https://orcid.org/0000-0002-1646-127X


Burnout, Primary Care, Rural, Provider Type, Practice Type


Behavior and Behavior Mechanisms | Family Medicine | Health Services Research | Medicine and Health Sciences | Occupational Health and Industrial Hygiene | Other Mental and Social Health | Other Nursing | Patient Safety | Primary Care | Quality Improvement



Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians.


Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling.


Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP and APRN/PA differed on sex ratio (p /= 65 vs under 0.178 (p 0.032). Severe burnout in WV PCP was 57.6% and in all US physicians 43.9% (p 0.015). The OR for severe burnout in PCP versus APRN/PA was 2.89 (p 0.039). Burnout in PCP > APRN in rural (p 0.046) but not urban. Private practice 17.6% in our population, 48% US physicians (p 0.0003). Burnout increased linearly with work hours (p 0.003). Self-estimate of burnout correlated with MBI results (p <0.0001).


Severe burnout was highly prevalent in this high risk specialty serving a patient population at risk in regards to poverty, age and medical complexity. This community had a low rate of private practice, fewer providers over age 65, a higher rate of burnout in physicians compared to APRN/PA, and a linear association of burnout to work hours. There was also validation of a single question burnout screening tool. High risk community systems could be a reservoir for burnout research and improvement there could reduce costs and improve outcomes.