A qualitative analysis of experiences of administrative burden in primary care: lack of control as a key driver of frustration and burnout

This is the authors' abstract. We don't add key points for this paper.

Purpose To examine the experiences of professionals working in primary care settings to understand how administrative work is perceived as a burden, considering both professional roles and current practice realities. Methods A secondary reflexive thematic analysis was conducted to understand challenges with administrative workload in primary care. We used data from thirty-six interviews with family physicians, nurse practitioners and administrative staff working in primary care clinics in two Canadian provinces. Results Initially we identified professional responsibilities in primary care including: i) transfer of information, ii) work that requires attention to privacy concerns, iii) clinical acumen, and iv) work that is weighted by various forms of moral obligation. Identification of these professional responsibilities situated the inductive analysis which followed. Subsequently a major theme was identified indicating that lack of control over administrative responsibilities is a key component of frustration and burnout. Sub-themes were: i) Lack of appropriate resources, training and control cultivates frustration with information management, ii) Government and industry processes along with patient demand add to burden of information stewardship, iii) Primary care is ultimately responsible for clinical management and coordination of care regardless of contextual factors, and iv) Moral obligation to support patients through administrative work comes at personal cost. Conclusions Though information management is central to administrative work, lack of control combined with information stewardship, and clinical and moral responsibilities contribute to experiences of administrative burden, burnout and moral distress. Addressing administrative burden requires support for information management, but also thoughtful responses to these complexities in primary care.