Physician Burnout & Busywork. More of a "thing" than ever.
In 2011, our co-founders Jonathan Baran and Lyle Berkowitz, MD started knocking on health system doors, talking about the pervasiveness of physician burnout and how technology can be used to address it. Dr. Lyle spoke from first-hand experience; as a primary care provider, he'd been (and continues to be) increasingly affected by the massive volume of clinical tasks hitting his in basket. We don't claim to be the first, last, or only people talking about physician burnout. There are some incredible spokespeople out there, making sure that this issue continues to get play. Thomas Bodenheimer, MD and Christine Sinsky, MD of the AMA come to mind, and we're lucky enough to have them as advisors.
As I've written blogs about this topic of the past 2.5 years at healthfinch, I keep thinking that I sound like a broken record. Creatively, it would be fun to write something new. But the reality is that this record needs to keep skipping until it annoys people so much that they're willing to tackle the some, if not all, of the root causes of physician burnout.
Last week, it was refreshing to come across an article in the Annals of Internal Medicine summarizing the American College of Physicians' strongly-worded position paper on administrative task volume.
"The growing number of administrative tasks imposed on physicians, their practices, and their patients adds unnecessary costs to the U.S. health care system, individual physician practices, and the patients themselves. Excessive administrative tasks also divert time and focus from more clinically important activities of physicians and their staffs, such as providing actual care to patients and improving quality, and may prevent patients from receiving timely and appropriate care or treatment. In addition, administrative tasks are keeping physicians from entering or remaining in primary care and may cause them to decline participation in certain insurance plans because of the excessive requirements. The increase in these tasks also has been linked to greater stress and burnout among physician."
Although burnout is a multi-faceted issue, there is little doubt anymore that administrative, below-license tasks are not only an incredible time suck, but cause serious dissatisfaction. If you're feeling super nerdy, check out an older but still relevant model for evaluating work satisfaction and work motivation created by American psychologist Frederick Herzberg. Lest you think providers are just crying fowl, there is real science behind their workplace complaints. Herzberg argues that largest contributors to job satisfaction are motivators like: achievement, recognition, growth potential, and the work itself. In this case the "work itself" is doctoring, not handling administrative tasks.* If up to 30% of a physician's day is spent on clinical tasks instead of patient care, it's no wonder why they report such high levels of dissatisfaction. And people who are dissatisfied often end up leaving their place of employ (or in some cases, their field altogether).
In a Health Affairs blog titled Physician Burnout Is A Public Health Crisis: A Message To Our Fellow Health Care CEOs:
"The result is that many previously well-adjusted and engaged physicians have been stressed to the point of burnout, prompting them to retire early, reduce the time they devote to clinical work, or leave the profession altogether."
The cost of physician turnover to a health system can be staggering. Many studies show that it can cost $1 million to replace a physician whose annual salary is about $250K. ** It only makes sense that a health system pay attention to burnout from a fiscal standpoint.
But it also makes sense that burnout is addressed because it can lead to more morbid results. Dr. Paula Wibel has a powerful Ted Talk on the pressures providers face and how it can lead to mental health issues and in the worst case, suicidal ideation.
Something has got to give.
At healthfinch we certainly can't help with every facet of physician burnout, but we can impact a few critical areas. We can leverage the EMR and our Charlie platform to reduce administrative task burdens, one of the American College of Physician's chief recommendations.
The ACP offers a nice diagram of how to get started, which is similar to what we offer our enterprise clients when we work with them on redesigning workflows. Practices must look at their tasks and ask:
- What is absolutely critical for a physician to handle?
- What tasks could be safely delegated to a nurse or a medical assistant?
- What tasks could be aggregated, organized, and teed up using technology?
- How do we pull all of this together and then automate it for efficiency?
Even those tasks that require physician judgement may be able to be delegated. Designing and approving protocols, for example, should be handled by physicians. But after these are standardized and approved, they can be rolled out and automated for staff to take action.
Data pulled from our own client base for March 2017 shows that we've processed nearly 500K clinical tasks. That's 1/2 million tasks made easier and faster for providers and staff!
Implementing our platform and/or similar technologies is such an easy win for providers and their staff. And, if we make an impact in this area, I can go on to blogging about the next big thing (no more broken records) ;)
Let's chat about practice automation and reducing busywork in your practice.
*One More Time, How Do You Motivate Employees" by Frederick Herzberg, Harvard Business Review, September-October 1987.