Hospitals where nurses report “enough nurses to get the work done” have better physician outcomes, according to a recent study published in JAMA Network Open Nov. 17.
Researchers drew on two clinician surveys covering 49 European hospitals and 56 U.S. Magnet hospitals. Physicians reported well-being and nurses independently rated staffing, environment and teamwork, which were linked to physician outcomes using adjusted hospital-clustered regression models.
Here are 10 things to know:
1. Across 105 hospitals and seven countries, high burnout, job dissatisfaction and intent to leave were common. This pattern held in U.S. Magnet hospitals, typically viewed as having better work environments.
2. About 24% of U.S. physicians and 30% of European physicians said they intended to leave their hospital within a year due to dissatisfaction.
3. Within the same country, some hospitals had far better physician outcomes than others, suggesting modifiable local conditions are driving a lot of the difference.
4. A 10-point increase in nurse staffing adequacy was linked to lower odds of physician intent to leave, burnout, dissatisfaction and not recommending the hospital, underscoring staffing as a physician retention lever, not only a nursing issue.
5. In U.S. hospitals, more favorable clinical care environments — defined by responsive administration, strong frontline management, clear care philosophy and clinician voice — were associated with lower odds of burnout, intent to leave, dissatisfaction and lack of employer recommendation.
6. Hospitals with stronger physician-nurse teamwork had better physician outcomes in both Europe and the U.S.
7. Fewer than half of U.S. nurses (about 44%) said staffing was adequate, highlighting a persistent gap in hospitals that are often considered high performers.
8. If hospitals improved nurse staffing adequacy to the 90th percentile, the model projected a 4.3-percentage-point reduction in U.S. physicians’ intent to leave. The 90th percentile benchmark equated to about 69% of nurses reporting adequate staffing.
9. Roughly 64% of U.S. physicians reported poor control over their workload, a figure even higher in Europe (about 74% overall).
10. The authors note that traditional burnout interventions, such as coaching, mindfulness and scheduling changes, show mixed impact. The study instead points toward higher-leverage organizational changes: nurse staffing, unit leadership, workflow supports and team design.
