Table 1.

Potential mitigating and exacerbating factors of eConsults on clinician burnout

	Mitigating Factors	Exacerbating Factors
Autonomy	Improved access to specialist input and decreased wait times3 Fewer inappropriate clinic visits and avoidable follow-up visits, liberating time to spend elsewhere6,7 Emphasis of value of eConsults to improve patient care to promote intrinsic motivation of clinicians8	Increased administrative workload8,9 Shift in burden of specialty care8 Additional tests or labs required8 Specialists as “gatekeepers”8 Increased referral volume10
Competence	Educational value of eConsult Improved knowledge and confidence in management of conditions11,12 Potential education value to medical graduate trainees13 Greatest benefit for midlevel providers, clinicians with fewer years of experience11 More appropriate allocation of specialty visits to patients who require in-person specialty care3	eConsult as a checklist that requires less clinical judgment8
Relatedness	Improved communication and relationships between providers12 Provider give support in unfamiliar situations or helps confirm diagnoses12 Improved patient relationships through better outcomes for patients and patient satisfaction14 Timely specialist input regarding patient care, minimizing wait times for specialist access3	Specialists as “gatekeepers” to in-person visit8 Impersonal communication8 Variation in quality of specialist reviewer responses8