New research examines factors contributing to burnout among primary care workers

The global COVID-19 pandemic brought into clear focus the physical, mental and emotional costs of working as a care provider in the American healthcare system. But even before the pandemic, up to half of clinicians were exhibiting at least one dimension of burnout.

New research from OccHealthSci, “Post-pandemic primary care burnout drivers: Interplay of organizational constraints, values (mis)alignment and team-leader dynamics” published in the Journal of Healthcare Leadership offers a sharper picture of why. According to the research team, the answer is more human—and more fixable—than many might think.

The research team, led by Oregon Institute of Occupational Health Sciences Associate Professor David Hurtado, Sc.D., surveyed 338 clinicians and support staff across 12 primary care clinics in Portland, Oregon in 2023. The research team mapped the simultaneous links of several workplace factors: organizational constraints, psychological safety, supervisor support, and—importantly—how well employees felt their values aligned with those of their leaders. To create their map, the research team used the Maslach Burnout Inventory, the gold-standard measure of occupational burnout, along with statistical modeling.

The results were clear. Among the five factors examined, the strongest association with emotional exhaustion (one of three components of burnout) was a values misalignment with leadership. The more values aligned, the more the research team saw a drop in emotional exhaustion among care providers. Another factor, organizational constraints—such as the availability of resources, scheduling and administrative overload—was linked to emotional exhaustion and another component of burnout: depersonalization, or the tendency to detach from work. Psychological safety refers to the degree to which workers feel they can speak up, raise concerns, or admit mistakes and is another factor the team examined. The team’s analysis of the survey data suggested that psychological safety is a significant predictor of emotional exhaustion.

The final two factors the research team examined were general supervisor support and family supportive supervisor support. General support, the kind that involves problem solving, mentoring, etc., bolstered workers’ sense of personal accomplishment (the third component of burnout). Family supportive supervisor support, interestingly, showed an inverse relationship with accomplishment. According to Hurtado, this might suggest a selection effect: workers who feel least professionally fulfilled may be most likely to lean on supervisors for family-related support.

The implications for healthcare providers are apparent. Aligning values is of critical importance—it may even be a clinical safety issue. According to Hurtado, training leaders to model psychological safety, closing the gap between institutional priorities and professional ethics of care workers, and reducing structural friction aren’t merely moral initiatives. They are, the data suggests, among the most powerful tools available for keeping the primary care workforce intact.

With projections warning of a shortage of up to 40,000 primary care physicians in the United States by 2036, the stakes could not be higher. The clinic of the future may depend less on better technology than on better listening.

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Hurtado, D. A., Ezekiel-Herrera, D., Boyd, J., Madjlesi, R., Hwang, J., Everson, T., Hammer, L. & Lenhart, A. (2026). Post-Pandemic Primary Care Burnout Drivers: Interplay of Organizational Constraints, Values (Mis) alignment, and Team-Leader Dynamics. Journal of Healthcare Leadership, 570686.