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Ensuring Physicians Thrive

How to Overcome Burnout Through Change Management, Collaboration and Technology

Courtesy of Joyseulay / Shutterstock
Courtesy of Joyseulay / Shutterstock

The medical profession has always been demanding, with unpredictable hours and many occupational stressors. And these demands continue to grow. Aside from interacting with different healthcare technologies, physicians are also tasked with managing the frequently changing requirements of insurers, government regulators and health systems, all while meeting expectations that we should also be accessible to patients almost 24/7. What’s more, in today’s era of value-based care, we face added pressure to improve practice efficiency, deliver better care and increase the customer patient base. In other words, we’re continuing to be asked to do more with less. 

It’s not surprising, then, that studies show U.S. doctors experience burnout symptoms at almost twice the rate of other workers. For most of us, there simply aren’t enough hours in the day. So, we end up working at home and late at night before bed, trying to complete paperwork and enter patient data into the electronic health record (EHR) — what we refer to as “pajama time.”

This is not acceptable for patients, for us as professionals, or for the overall economy and health of the country. In fact, doctors who are overworked, dissatisfied with their jobs, and on the verge of quitting cost the United States $4.6 billion annually. And burnout also contributes to many other negative factors, including physician shortages, another key concern for our profession.

Working Together: Uniting the Healthcare Industry to Identify a Solution

Doctors alone cannot resolve these issues. It requires collaboration among numerous groups — from government entities and payers to technology vendors and hospitals — to address these factors and combat burnout at its root cause once and for all.

One way to do this is by streamlining workflows and giving doctors more control over their daily responsibilities. As a start, we need to address cumbersome rules impacting our profession. A recent report noted that 27% of physicians said slashing regulations would reduce burnout, because they’d be able to better focus on caring for patients rather than doing administrative paperwork.

The Centers for Medicare & Medicaid Services (CMS) aims to address this. In launching its “Patients Over Paperwork” initiative, physicians who have identified confusing and/or time-consuming documentation are encouraged to report them to CMS. By hearing from physicians directly, CMS intends to reduce unnecessary burden, increase efficiencies, and improve the beneficiary experience.

While I believe these sorts of initiatives can be impactful, we must also pay attention to the role of healthcare technology in combating burnout, as well as the impact burnout will have on future generations of physicians. Let’s explore.

Technology Can Help: A Focus on Next-Generation EHRs

Technology, too, is said to have complicated our lives. Consider first-generation EHRs, which were touted as a way to help us become more efficient. In reality, they had the opposite effect.

I believe these EHRs were rushed to achieve market advantage. These early edition EHRs were frequently proprietary solutions that didn’t interoperate with other systems, creating more work for doctors who were trying to streamline care coordination and improve efficiency as they transitioned to value-based care. In addition, there wasn’t enough thought given to how the solutions fit into workflows, nor was it considered how rigid EHR processes would force doctors to change the way we worked every day. This learning curve, plus a lack of sufficient end user design and training, often prevented us from becoming proficient. In fact, studies show that doctors who felt they had poor training were 3.5 times more likely to report that their EHR did not enable them to deliver quality care. Despite these early pitfalls, I see real opportunity for technology to help us achieve our goals of reducing burdens on physicians, streamlining workflows, and enabling better care.

The foundation of any new solution, however, must take into account a variety of perspectives to validate the idea or provide input on ways to improve usability or physician impact. Artificial intelligence, voice recognition, and natural language processing are among the technologies vital to revolutionizing healthcare and addressing factors that lead to physician fatigue. With these capabilities, we can reduce the number of “clicks” required to handle administrative functions and data entry. In addition, next-generation EHRs must be designed to integrate and interoperate with other systems on which we rely, driving significant improvements in patient care, collaboration, documentation, and efficiency.

Bottom line: New technology solutions must reinvent the way physicians work, allowing us to focus on our core responsibility of providing quality patient care.

Beyond Technology: Empowering Medical Students and Universities

The effective use of properly designed technology is not the only way to combat physician burnout. We need to start early — with medical students and residents who show signs of burnout even before they enter the field full-time.

Medical schools and programs must put greater emphasis on student wellness. Schools like Vanderbilt University, for example, promote students’ physical, emotional/spiritual, interpersonal, academic, professional, environmental and community needs.

The financial stress burdened on these students also cannot be discounted. On top of daily workplace stressors, many aspiring doctors also worry about the costs associated with the job, which is why offerings and scholarships like the Sharp Index Scholarship exist. Designed to reduce physician suicide and burnout, the scholarship is granted to one medical student or resident interested in improving physician well-being.

I’d like to see even more universities and influencers implement these types of programs and scholarships to help aspiring physicians better manage the demands of working in healthcare and prevent feelings of burnout from the start.

Burnout is a systemic problem, and it’s only going to get worse if we don’t fight it. We’re at risk of losing interested and experienced doctors, which will have significant implications for healthcare for all. To address this issue, it’s imperative the industry works together to assess root cause regulatory and reimbursement burdens, ensure that new technology is being employed with the goal of truly easing physician workflows, and that we take time to address how the demands impact both our personal and professional well-being. By combining this with proper workplace policies and a ‘change management culture,’ we can enable our physicians — and their patients — to thrive.

About the Author

Chief Medical Officer Dr. Geeta Nayyar is a nationally recognized leader in health information technology, bringing the physician’s perspective to Greenway Health’s services and solutions. Before joining Greenway, she was Chief Healthcare and Innovation Officer at Femwell Group Health, Inc., one of the largest management services organizations in Florida. During her tenure, Dr. Nayyar was instrumental in creating and launching innovations around physician and patient engagement technologies. She is also the former CMIO for AT&T. Dr. Nayyar earned her Doctor of Medicine and Bachelor of Science degrees from the University of Miami, and a Master of Business Administration from The George Washington University. She is an Assistant Clinical Professor of Medicine at Florida International University, where she maintains an active rheumatology practice.

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