Federally qualified health centers are designed to provide better access for poor and minority populations, in both urban and rural settings. They are funded by the federal government, as well as by states and private donations, and they generally participate in Medicaid and Medicare, and accept private pay patients. The clinicians are typically on salary. As with all providers, these Centers have been under great pressure to transform how they deliver care, including being medical homes and using more health information technology. Researchers conducted a survey of FQHC staff in April–August of 2013 and June–October 2014 to ascertain levels of and issues with job satisfaction and compared changes over that period of time. The results are reported in a Health Affairs article. (HA Article) The 503 center sites included in the study had participated in and Advanced Primary Care demonstration that CMS ran from 2011 to 2014.
The survey asked about overall job satisfaction, burnout, intent to change jobs, practice culture and work environment. From the first survey to the second one, overall work satisfaction declined from 84% to 74%. The percent reporting feeling burned out rose from 23% to 31.5%. The proportion saying they wanted to change jobs within two years also increased, from 29% to 38%. Out of five work environment measures, three showed substantial decline and 12 of 13 practice culture measures declined. In particular, there was a greater proportion of respondents reporting a hectic/chaotic practice atmosphere, and ratings for teamwork and facility leadership declined significantly. The results from this survey are consistent with broader surveys physicians, which also find greatly increased rates of burnout and widespread dissatisfaction, particularly with administrative burdens and regulatory requirements. FQHCs are a very important part of our health system. They generally provide low-cost, good quality care for populations which often have access problems. I think they should be the providers that must be used by people on Medicaid, to keep the costs low for that program. So it is important for some policymaker somewhere to figure out how to keep staff at these centers satisfied.