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Working conditions in primary care: physician reactions and care quality.
Linzer M, Manwell LB, Williams ES, et al; MEMO Investigators. Ann Intern Med. 2009;151:28-36.

The quality and safety of care in the ambulatory setting may require a different framework for assessment and improvement from that often applied in the hospital setting. The relationships between work environments and the care delivered in those environments similarly may differ between care settings. This AHRQ-funded study found that more than half of surveyed physicians reported time pressures during office visits and low control over their work, though only a quarter reported burnout. While adverse workflow and poor organizational culture were associated with adverse physician reactions (e.g., low satisfaction, stress, and burnout), there were no associations between these reactions and care quality or errors. This study builds on past analyses of these relationships from the same investigative team.

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