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Strategies for Reducing Physician Burnout

Strategies for Reducing Physician Burnout

The fastest growing ailment seen in doctors' offices across the country very well may be the rising rate of physician burnout.

The American Medical Association (AMA) and the Mayo Clinic conducted multiple studies of more than 6,000 physicians in 2011 and 2014 on the topic of burnout. In just three years, the rate of physicians who reported at least one symptom of burnout went from 45.5 percent to 54.4 percent.

"This is the best evidence that the burnout rates are the highest they've ever been," says Christine Sinsky, MD, AMA's vice president of professional satisfaction.

This is not the only study that shows the seriousness of the issue. The Physicians Practice Great American Physician (GAP) Survey surveyed 1,314 physicians, who overwhelmingly reported the profession was more stressful and less financially lucrative than in years past. Respondents to the GAP Survey also said they were not happy with the direction healthcare is headed.

These metrics have been amped up, experts say, because of various outlying factors. Chief among them is the introduction of the EHR to medical practices. "What has made us more vulnerable [to burnout] in the past five to 10 years is some of the environmental changes. They are good changes, but some of it results in more work. Everybody loves EHRs … they give us information [at the point of care], but it takes more work to put the information in for physicians than it used to be. It adds like 25 percent more time," says Christy Sandborg, MD, vice president of medical affairs and professor of pediatrics at Lucile Salter Packard Children's Hospital in Palo Alto, Calif.

To this point, AMA partnered with Lebanon, N.H.-based Dartmouth-Hitchcock Health System for long-term observations of 57 physicians across four specialties in four states. What they found was that physicians spent nearly half of their time on the EHR and less than a third of their time face-to-face with patients. "In addition, the physicians were taking 1-2 hours of EHR and desk work to be done at home," Sinsky says.

What has likely driven the distaste for the EHR is that the government mandated physicians adopt them through the Health and Information Technology for Economic and Clinical Health (HITECH) Act. Lisa Roark, MD, family physician for a direct primary care (DPC) practice in Cassville, Mo., says Meaningful Use — the EHR Incentive Program, part of HITECH, mandating physicians to adopt a certified EHR or face a financial penalty— forced her to work longer hours for less money, while seeing the same amount of patients. When the health system she was working at offered a 5-year renewal contract that would force her to work even longer hours while still adhering to Meaningful Use, she decided to leave the fee-for-service world entirely.

Indeed, physicians responding to the GAP Survey said their number one frustration with healthcare was third-party interference. Not only has this come in the form of Meaningful Use and other government regulations, but administrative paperwork related to value-based quality metrics as well. Roark says by being a DPC doctor, where her patients pay membership fees and she does not take insurance, she doesn't have to answer to the government on how she's doing, for instance, with her diabetic patients. These administrative tasks have added to the overall sense from physicians, Sinsky says, that they aren't doing the work they were trained to do.  

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