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September 13, 2016
3 Leading Causes of Physician Burnout — and What You Can Do
Approximately 87% of physicians have reported experiencing moderate to severe stress, and about half have experienced signs of burnout. Maximizing returns on value-based care reimbursement models is partly reliant on positive patient experiences. However, if the goal is to provide high-quality patient care, then shouldn’t we focus on what healthcare providers need to achieve this?
Time and again, electronic health records (EHRs) come up as a reason physicians are facing burnout and feeling they don’t adequately engage with and support patients. Frustrations with using EHRs, leading to mountains of administrative work that seem counterproductive to the pressure to see as many patients as possible, need to be addressed.
The American Medical Association (AMA) has determined eight “usability priorities” that would help fix the issues associated with EHR use:
- Enhance physicians’ ability to provide high-quality patient care
- Support team-based care
- Promote care coordination
- Offer product modularity and configurability
- Reduce cognitive workload
- Promote data liquidity
- Facilitate digital and mobile patient engagement
- Expedite user input into product design and post-implementation feedback.
Here’s a look at three solutions that don’t involve changing out your EHR system.
Patient/physician interaction and communication
Plain and simple: EHRs are not user-intuitive enough to allow for quality patient engagement. A recent study published in the Mayo Clinic Proceedings has reaffirmed a link between the use of EHRs and physician burnout, spurring organizations such as the Mayo Clinic to investigate the use of medical scribes to unburden physicians with regard to data entry at the point of care.
Physicians trained long and hard to become good doctors who provide excellent patient care, not good clerical workers. Clerical work is critical to the functioning of any practice or hospital — but doing both at the same time detracts from interaction with the patient, in-depth information gathering and discussion, and patient education. When scribes take on real-time data entry, physicians are free to focus solely on the patient. Instead of fiddling with a computer system, the physician is making a diagnosis, ordering tests and medications, and giving the patient information about their condition. That’s the kind of scenario that provides a physician with job satisfaction at the end of the day.
Use a team to support patient care
Patient care is not a one-person game. It never really was, but with the Centers for Medicare and Medicaid Services (CMS) calling for more and better care coordination, the teamwork aspect of medicine has become codified. Especially for patients with multiple comorbidities or complex conditions, or those whose conditions require inpatient admission, myriad processes need to happen in a short amount of time, without compromising quality of care. For example, in busy inpatient departments, there are a lot of moving parts to manage: physicians overseeing care, nurses monitoring patients, pharmacies dispensing drugs, diagnostics carrying out tests, allied health professionals supporting care, and more.
In addition to documentation, scribes can be tasked with delivering messages, providing reminders to physicians, collecting reports from diagnostics and tracking time spent on tasks. Physician assistants or advanced practice nurses can aid in patient supervision and care during admission, involving a physician only as necessary. Nurse educators can go into detail on information provided from physician to patient, alleviating a further burden on time when more patients are waiting to be seen. These support efforts, combined with removing data entry from physicians’ shoulders, add up. The team-based approach makes the most of the strengths and skills of every member, relieves inappropriate workload burdens through task delegation, and provides a support system that lets each member optimally contribute to high-quality care.
Physician engagement and empowerment
Just as patients need to be engaged as part of their care, doctors, too, should be empowered to prevent their own burnout. Only 20% of physicians are fully engaged with the healthcare institutions that hire them — a harbinger of physician burnout. Physician burnout can be expedited when doctors lose the incentive to practice — or, more often, lose the desire to engage with a healthcare system that doesn’t provide them with the means to practice. The drive to lower costs and increase efficiency can sometimes make it seem that medicine is losing sight of patient care.
Instead of simply dictating the parameters, healthcare organizations should create physician-led committees to help find practical, low-cost solutions and lead the drive for change without compromising patient care. Engaging physicians in these activities, so they can directly influence care and outcomes, leads to better physician buy-in and higher physician satisfaction with their work.
In addition, healthcare organizations should strive to create an atmosphere of support that is non-punitive when physicians speak up about needing help. The first step to fixing the problem of physician burnout, then, is admitting that physicians are human beings who are susceptible to burnout.
“The healers can’t heal without caring for ourselves,” said Jamin Brahmbhatt, MD, in a recent Medscape roundtable. “We need to sleep, we need to exercise.”
Working within an organization that values all aspects of physician well-being goes a long way toward reducing burnout — and helping evolve the business of healthcare for the better.