Physicians are burning out at alarming rates, and we should all be paying close attention.
For physicians, the negative health effects have serious consequences. Physicians now have the highest suicide rate of any profession In real terms, one physician is lost in the U.S. every day to suicide. This is an epidemic affecting all service lines, women and men, across rural and urban settings. Stories of depression, lack of desire to perform at a high level, and chronic fatigue abound.
Obviously this is impacting patient care. This makes conceptual sense—a burnt out provider will be less effective, resulting in declining outcomes, reduced patient engagement, frustration in the ‘system’ and poorer population health. And while the human costs are highest and most important, there are also financial costs for health systems and practices. Discussed at a panel at this year’s Becker’s Hospital Review Health IT + Clinical Leadership 2018 Conference, Dr. Tim Lineberry of Aurora Health made an important statement about physician burnout: “Burnout is a business issue. If you lose one physician … that's an immediate issue from a revenue standpoint.” This makes a troubling human issue a troubling business issue for health systems and hospitals.
One industry-wide, measurable effect of physician burnout is a physician shortage. Recent research by the Association of American Medical Colleges (AAMC) predicts a physician shortage of 100,000 by 2030. This shortage will be partially caused by physician burnout while simultaneously driving physician burnout, as efficiency and productivity expectations continue to increase for physicians. The result is an accelerating and deepening crisis.
How can we address physician burnout?
Many experts have pointed to the EMR as a primary culprit for physician burnout. This is because physicians spend roughly 50% of their day interfacing with an EMR. One solution to the EMR issue is to increase the usage of scribes. Currently underutilized, scribes are proven to improve physician satisfaction and reduce burnout by cutting the time a physician spends on documentation in half.
Scribes are certainly not the only group that can help address physician burnout. To more directly address the current physician shortage, policy and regulatory changes should be made to place more investment in Nurse Practitioners. A growing base of skilled providers, Nurse Practitioners are crucial to filling care gaps and to meet patient needs that do not require a physician. Given limited time and resources, physicians need to focus on the most urgent and crucial medical needs of the population, and leave pap smears and other procedures to other providers who are trained and able to give quality care.
The Keys to Any Physician Burnout Improvement Strategy
Most importantly, addressing physician burnout requires a clear strategy that takes into account the following components. According to Karen Weiner, CEO of Oregon Medical Group, “Best practice is to identify the sources of stress for the physicians of that particular setting, identify relevant interventions, create metrics with baselines and goals, then watch closely for improvements over time, and tweak the interventions as needed.” Following this expertise, there is no silver bullet or one-size-fits all solution to address physician burnout. The daily sources of stress for an orthopaedic surgeon will differ from the sources of stress that an urgent care provider has.
Technology: Friend or Foe?
What role can technology play in addressing physician burnout? Is technology only a hindrance? If utilized for peak performance, technology can alleviate some daily stressors for physicians:
Patient intake and workflow management - for physicians who view decreasing control over their schedules as a daily source of stress, there are solutions that address patient intake and workflow management. The goal of these solutions is to replicate nuances, like intake protocols and custom workflows, within the provider’s schedule. This ensures the right patient sees the right provider at the right time.
Algorithm-driven patient navigation - allows the patient to be ‘steered’ to the optimal provider. This could be closest/soonest, a member of the care team, or a Nurse Practitioner or Physician Assistant, all designed to alleviate the schedule stresses of the physician and her or his practice management system.
Telehealth - a key component of the physician shortage issue, and by extension physician burnout, is location. There are not enough providers in certain localities. Telehealth solutions exist that take location out of the equation, allowing greater access to care for otherwise underserved communities. For these localities, greater access to telehealth translates to decreased burden on local providers.
Healthcare IT compliance automation - in a highly regulated environment, physicians need automation to remain in compliance with all regulations. Solutions that automate compliance lessen the burden on physicians and support staff when it comes to compliance.
In summary, there are a multitude of methods to address the physician burnout crisis including manpower and technology. Prior to implementing any solution, however, the first and most crucial step is to listen to providers, determine their top sources of stress, implement solutions and refine them on an ongoing basis. This strategic thinking and listening should guide any and all investments in alleviating physician burnout. The human issue of physician burnout will only be solved by listening to physicians and addressing their specific needs.