Team-Based Care: Caring for the team under payment reform

  • Mark Linzer
  • Becky R. Ford
  • Katherine F. Guthrie
  • Katherine Diaz VickeryEmail author
Concise Research Report


The epidemic of burnout among clinicians is well documented1. Less is known, however, about stress and burnout among staff2, particularly in safety net settings. As many organizations aim to reduce clinician burnout, and as an era of team-based care brings opportunity for sharing the care among multiple team members, the potential impact on work–life and wellness among other staff members remains to be determined. We examined burnout among all team members using data from a project on impact of payment reform on safety net health care clinicians, staff, and patients. We explored whether certain aspects of teamwork might be associated with lower burnout. The answers to these questions would provide the substrate for future studies to determine mechanisms to reduce burnout among all care team members.


Interviews were conducted with staff and clinicians to design survey questions about awareness of payment reform. The single-item question on burnout, validated against...



We acknowledge Dr. Eileen Harwood’s help in planning and development of the survey and support in data analyses.

Funding Information

This paper was supported by a grant (no. 73615) from the Robert Wood Johnson Foundation.

Compliance with Ethical Standards

Institutional Review Boards at Allina Health and Hennepin Healthcare Research Institute approved this study while the University of Minnesota deemed the study exempt from requiring consent.

Conflict of Interest

Dr. Linzer works with AMA, Institute for Healthcare Improvement, and the American College of Physicians on clinician work–life improvements. Dr. Guthrie reports that her husband owns stock in Merck and Express Scripts. The other authors report no conflicts.


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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  1. 1.Hennepin HealthcareMinneapolisUSA
  2. 2.Hennepin Healthcare Research InstituteMinneapolisUSA
  3. 3.Allina Health, United Family MedicineSaint PaulUSA

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