Short communication: A proposed physician-patient cycle model

Understanding the effect that physician stress and burnout have on patient outcomes is important to improving the quality of care. The physician-patient cycle model documents the virtuous or vicious cycles which can ensue when clinicians deal effectively or ineffectively with stress and burnout. The model starts with excessive stress beginning the physician burnout process. Ineffectual physician responses to burnout, including depersonalizing behaviors, negatively affect the quality of the medical encounter. Poor quality encounters engender low patient satisfaction, poor compliance with medical treatments, and more patient assertiveness. For physicians, these patient attitudes and behaviors may be perceived as patient demands and experienced as additional stressors, perpetuating a vicious cycle. The model contributes to the knowledge base on stress and health by synthesizing various studies that have examined physician stress and burnout as they impact patient outcomes. A major implication is that the well-being of physicians is a key ingredient to the provision of quality medical care.