Physicians Struggle to Maintain Balance Amid Organizational Change, According to athenahealth Study

Physician Sentiment Index shows the impact of organizational changes and consolidation on physicians during the COVID-19 pandemic

WATERTOWN, Mass.--()--athenahealth, Inc., a leading provider of network-enabled software and services for medical groups and health systems nationwide, today announced survey findings from its second Physician Sentiment Index 2021 report. The survey was fielded between October 13, 2020, and December 23, 2020, to a broad sampling of physicians using a variety of EHR vendors – and was conducted to understand how physicians feel about the resources and support they receive to do their job in an effort to better identify and address opportunities to fortify U.S. essential healthcare workers. The physicians answered questions related to organizational issues, technological challenges, physician wellbeing, providing quality patient care, and more.

Do organizational changes create setbacks?

One finding from the survey shows that, since late 2018, more than 50% of the respondents experienced major organizational changes, including staff layoffs and furloughs, mergers and/or acquisitions, or new technology implementations. Healthcare continues to consolidate at a rapid pace, as mergers and acquisitions proliferate. Under normal circumstances, these organizational changes can take a toll as they disrupt workflows, job responsibilities, professional relationships, and more.

Of the major organizational changes we studied, going through a merger or acquisition made respondents less likely to say they intend to stay with their organization (58% vs. 74% who weren’t affected) or recommend it to friends or family members for care (68% vs. 85%), because of uncertainty around future roles and workplace culture. They reported feeling inspired to go above and beyond less frequently (63% vs. 78%) and less safe and supported (47% vs. 72%) by their organizations.

These respondents seemed to suffer especially in their personal connections with colleagues. Physicians who underwent some type of M&A did not feel as positive about their collaboration with physician colleagues (52% vs. 63% who weren’t affected), quality of non-physician colleagues (48% vs. 62%), top-of-license care (41% vs. 59%), and the quality of their immediate supervisors (45% vs. 69%).

Opportunities to improve physician morale

What can practices do to improve clinicians’ experiences at work and reduce burnout? The survey data suggests that when organizations take on a team-based primary care model – where physicians and allied health professionals take collective responsibility for a population of patients – physicians were far more likely to report positive opinions of their colleagues, reported more collaboration with other physicians, and rated their organizations’ leadership more positively in general.

To improve morale, the data showed that organizations can also support physicians by fostering a culture in which they feel safe, supported, able to share opinions freely, and heard.

The healthcare industry is not pandemic-proof

While the health sector has historically been able to weather economic recessions, it is not pandemic-proof. Medical groups and hospitals were focused on combating COVID-19 while elective procedures and routine exams plummeted, causing healthcare organizations to cut costs and reduce payroll. According to athenahealth’s data from the survey, during the pandemic, 28% of physicians experienced temporary furloughs and 14% experienced layoffs at their organizations. These physicians reported feeling more burned out (50% vs. 44% who were not affected), and experienced feelings of callousness (31% vs. 23%), and isolation (37% vs. 30%) at least a few times a month.

Technology transformations

23% of physicians reported going through a major technological transition in the past 24 months, such as implementing a new EHR system.

These physicians were, predictably, far more frustrated with their EHR than others – and less likely to believe they had received sufficient training. More broadly, they were less likely to feel technology helps them deliver high-quality care. It is likely some of this sentiment can be mitigated with deliberate, proactive training, and support around technology changes.

“The Physician Sentiment Index survey reflects the taxing impact of industry consolidation, technology changes, and layoffs/furloughs during the pandemic,” said Jessica Sweeney-Platt, vice president of research and editorial strategy at athenahealth. “This makes it even more notable that on balance, physicians continue to be committed to delivering superior patient care. The key for this result is a strong support system, proactive technological trainings, and ability to collaborate effectively with colleagues.”

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The survey results are based on 799 physician respondents (both athenahealth EHR and non-athenahealth EHR users) who completed the survey between October and December 2020. 54% of survey respondents described themselves as men, 41% women, 1% other (agender, genderqueer, gender questioning, or transgender), and 4% did not report on gender. Most respondents (64%) were from independent practices followed by hospital-affiliated practices (22%). A smaller share of respondents was represented by FQHCs and new care delivery models that included direct primary care clinics, urgent care centers/retail clinics, and concierge clinics.

About athenahealth, Inc.

athenahealth partners with medical organizations across the country to drive clinical and financial results. Our vision is to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all, and we are pursuing this through our medical record, revenue cycle, patient engagement, and care coordination service offerings. Our expert teams build modern technology on an open, connected ecosystem, yielding insights that make a difference for our customers and their patients. For more information, please visit


Jean Borgman


Jean Borgman