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Practice Environments and Job Satisfaction in Patient-Centered Medical Homes

The Issue

The provision of primary care is essential to a healthy population and a well-functioning health system. Primary care providers, however, report less job satisfaction than other physicians, and job dissatisfaction has been shown to be a cause of quality problems in physician practices. By seeking to promote a better work environment and enhancing practice resources, the patient-centered medical home has the potential to enhance job satisfaction of doctors and office staff. In this Commonwealth Fund–supported study, researchers collected data from primary care practices participating in medical home projects in Rhode Island and Colorado from 2009 to 2011.

What the Study Found

Within 30 months, job satisfaction had improved among primary care providers in the Rhode Island practices, but not in the Colorado practices. In both cases, there was a decrease in reported difficulties with providing safe, high-quality care, but the emphasis on quality and the level of “office chaos” did not change significantly.

Analyses showed that fewer difficulties in providing safe, high-quality care and more open communication were associated with greater job satisfaction. In contrast, office chaos and an emphasis on electronic information were associated with greater stress and burnout.


The benefits of the Rhode Island and Colorado medical home interventions may have been countered by the stresses caused by the transformation process. The researchers note that strategies aimed at reducing stress, such as reduced patient panel sizes, longer patient visit times, and dedicated time for care coordination, were not included in the interventions studied.

Publication Details

Publication Date: July 15, 2014
Contact: Shehnaz Alidina, Global Health Systems Researcher, Harvard Medical School
Summary Writer: Deborah Lorber
Citation: S. Alidina, M. B. Rosenthal, E. C. Schneider et al., “Practice Environments and Job Satisfaction in Patient-Centered Medical Homes,” Annals of Family Medicine, July–Aug. 2014 12(4):331–37.


Global Health Systems Researcher, Harvard Medical School
C. Boyden Gray Professor of Health Economics and Policy, Harvard T.H. Chan School of Public Health
Eric C. Schneider, M.D.
Senior Vice President for Policy and Research, The Commonwealth Fund
Natural Scientist, RAND Corporation