Physician Burnout: Latest Findings and Recommendations

Physician Burnout: Latest Findings and Recommendations

While there are many reasons for physician burnout, recent reports identify the clerical burden associated with EHR technology as the topmost cause.

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The latest findings on physician burnout in the U.S. show that the problem continues to loom large, affecting physicians’ wellbeing and their interactions with patients and colleagues. All studies report that inefficiencies related to the electronic health record (EHR) are a major burden for clinicians. Though this concern can be addressed through medical transcription outsourcing, experts say that physician burnout is a multifaceted problem that requires collaborative strategies involving all stakeholders in healthcare delivery.

Physician Burnout – Recent Statistics The results of Medscape’s 2018 National Report on Physician Burnout and Depression are startling. Nearly two-thirds of U.S. physicians reported feeling burned-out, depressed or both. One in three physicians admitted that their feelings of depression have an impact on how they relate to patients and colleagues. The key findings of the survey are as follows:

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The top five specialties with the highest rates of burnout are: critical care medicine, neurology, family medicine, ob-gyn, and internal medicine were the. Burnout rates were the lowest in plastic surgery, dermatology, pathology, ophthalmology and orthopedics.

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When asked about the reasons for burnout, 56% percent of physicians reported too many bureaucratic tasks such as charting and paperwork contributed to burnout, 39% reported spending too many hours at work and 24% pointed to increased computerization of practice.

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The survey found that physician depression impacts patient care. About one-third of physicians reported that they are easily exasperated and 32% of physicians said they were less engaged with patients because of depression.

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Exercise, talk with family members/close friends, and sleep were top strategies used to manage burnout.

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Physicians’ solutions to reduce burnout included increased compensation to avoid financial stress (35%), more manageable work schedule/call hours (31%) and decreased government regulations (27%).

In April 2018, the American Medical Association (AMA) reported on a survey conducted by Carilion Clinic, the largest nonprofit multispecialty integrated health system in Western Virginia. Carilion Clinic is known for its efforts to tackle physician burnout. The survey revealed found that

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59% of Carilion Clinicphysicians were experiencing high burnout

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50% of medical students, physician assistants and nurse practitioners also reported burnout

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burnout was the worst among residents

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Inefficiencies related to the electronic health record that were a major burden for their clinicians included extensive time spent after hours on the EHR, poor data-entry skills, ineffective EHR templates that break down charting workflows, and overuse of EHR “best practice advisories”

Cleveland Clinic is also in the forefront when it comes to tackling physician burnout.

According to a recent survey on physician burnout at Cleveland Clinic, 35 percent of the 1,145 respondents met criteria for overall burnout. The researchers noted the limited time for completing the significant administrative tasks associated with patient care as the key reason for the problem.The lead author noted, “Physicians who spend more time providing patient care end up emotionally depleted. This likely stems from limited time for completing the significant administrative tasks associated with patient care.”

A study published May 8, 2018 in the Annals of Internal Medicine noted thatwhile many factors contribute to burnout, the physician's interaction with EHRs is especially important with the increase in EHR adoption rates across the country. The researchers lauded the potential of EHRs to improve care, but noted that they have great “perverse effects”. They highlighted the results of studies which found that physicians spend as much time on computerized tasks as they do interacting with patients, which compromised their relationship with patients. Most physicians reported that EHR is driving professional dissatisfaction and burnout.

Latest Efforts to keep Physician Burnout at Bay Experts acknowledge that it is not easy to promote physician wellbeing, given that most specialists operate in a high-stress environment. However, institutions like Carilion Clinic are setting the example by taking steps to provide primary care physicians with more comprehensive administrative support so that they can focus on their patients:

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Use of speech-recognition software or scribes

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Support from healthcare workers to update documentation, negotiate with insurance companies, and have information ready when patients arrive for appointments.

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Patients are advised to have their blood tests in advance of their appointment, so the results will be available when they come to the exam room.

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An online portal allows physicians to communicate easily with patients and also helps patients schedule appointments online.

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Physician peer-to-peer work to improve EHR proficiency

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Working with IT to address poorly designed templates

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Improving the wellbeing of nurses and all other members of the care team

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Enhancing visibility and sharing between groups, including focus on specific groups, such as female clinicians

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Administrative and managerial support tohelp advance ongoing work related to leadership development and physician well-being

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Expansion of education and development programs for physician and administrative leaders to include information on the impact of leadership on clinician burnout

Cleveland Clinic also has special measures in place to tackle physician burnout. Their ongoing programming is designed to comprehensively support physicians, explore and share practice efficiencies. This includes coaching, peer mentorship and professional fulfillment training.

Addressing EHR Burden can Reduce Physician Burnout While there are many reasons for the physician burnout problem, all reports point to the regulatory and clerical burden associated with EHR technology as the topmost cause.

Medical transcription services can play a key role in addressing the physician’s struggle with EHR documentation. Medical transcription outsourcing allows healthcare providers to dictate their reports and get them inserted into specific sections of the EHR patient note template.

This documentation model effectively captures HER capabilities without compromising the integrity of the medical record.

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