Physician burnout is a true and growing threat to doctors, patients, and the healthcare system as a whole, and it is not going to resolve itself on its own. It’s time to start thinking about solutions to this impending crisis.
In a recent survey, 68 percent of US-based physicians reported experiencing some level of burnout. Overall, burnout was higher among younger physicians; primary care physicians reported higher burnout rates than specialists. Participants were asked what would help ameliorate burnout. Popular solutions included increased support staff, mandatory vacation time, and reduced patient volume.1
All of those things sound great in theory, but execution may prove difficult, given economic constraints and the dearth of physicians in some rural areas and certain specialties.
Other bodies call for more specific workflow changes as well as taking a hard look at Electronic Health Records (EHR) design. Doctors at an academic general medicine clinic in San Francisco reduced physician burnout after they adopted four workflow changes, a study found.2
The practice adopted a call management system where patients resolve their phone calls on the first touch and an inbox management and coverage system allows nurse practitioners to check physicians’ inboxes to see if patients need assistance. In addition, physicians were given more time for documentation and inbox management during the day, and new care team members took on such responsibilities as agenda setting. It worked well. Burnout fell from 56 to 31 percent, and stress levels dropped from 88 to 63 percent. Not bad, but these may not be effective solutions for all practices.
Many have blamed burnout on the pressure to adopt and “meaningfully” use EHRs, but the latest study shows that EHRs are not soley to blame. The findings3 show stressful work conditions, such as office atmosphere, workload control, and lack of work-life balance and value alignment with leaders play a role.
EHR factors most significantly associated with burnout were information overload, slow system response times, excessive data entry, inability to quickly navigate the system, “note bloat,” interference with the patient-clinician relationship, and notes geared toward billing.
Software developers should take note, but taken together, these suggested solutions point to a simpler truth. Doctors want to…be doctors. I recently read an article in the Washington Post that resonated with me. The author noted that surgeons are least likely to experience burnout despite the fast-paced, often life-and-death nature of their jobs.4 The reason? They are immune to paperwork and other pressures when they are in the OR doing what they love and what they were trained to do. By contrast, other physicians spend more time on administrative tasks and battling insurers than they do caring for patients or conducting research. The solution to physician burnout lies in the past, not the future.