Do breast cancer patients receive less support from physicians in German hospitals with high physician workload? A multilevel analysis.

Objective: Little is known about how organizational factors influence the patient-physician interaction. This study investigates the relationship between physician workload in hospitals and breast cancer patients' perceptions of the support provided by physicians.

Methods: Data from 1844 newly diagnosed breast cancer patients treated in 35 breast cancer center hospitals in the German state of North Rhine-Westphalia in 2010 were combined with data from 348 physicians from the same hospitals. Multilevel logistic regression models were calculated using 31 hospitals with complete patient and physician data. Patients' perceptions of physician support were studied in relation to physician workload in hospitals.

Results: Breast cancer patients perceived themselves as receiving less support from physicians when treated in hospitals where physicians reported working more overtime hours and having less time for patient care.

Conclusion: This study provides preliminary evidence of the association between the hospital work environment and physicians' ability to support patients. Future studies should investigate the extent to which physicians' interaction performance can be modified through hospital-level interventions aimed at managing workload.

Practice Implications: By approaching the problem of physician staffing in hospitals and investing in the hospitals' working conditions, health policy and hospital management could create conditions conducive to better patient-physician interaction.