A recently released report by Medscape has the healthcare industry buzzing about news that comes as no surprise: physicians are burned out. Forty-two percent of those surveyed feel the effects of burnout, including unrelenting, long-term, job-related stress. What’s to blame? Largely, the administrative burdens of practicing medicine.
Sadly, the state of physician burnout isn’t limited to a healthcare specialty or physician age. The reported burnout is wide-spread across age groups and specialties. However, doctors in the middle of their careers and those in fields including family medicine, primary care, and emergency medicine are among the most likely to feel the burn. Fortunately, there are initiatives and tools aimed at easing administrative burdens and giving physicians back control of their time and profession.
Decades of Change
A Medical Economics Physician Report found that nearly 80 percent of doctors cite administrative burdens, including paperwork and regulatory requirements, as the top challenge they experience in practice. Mundane tasks, such as documenting and charting, cause endless frustration. More importantly, they take physicians’ time away from patients.
It is estimated that doctors today spend just 27 percent (Annals of Internal Medicine) of their time interacting with patients. The remaining time—far exceeding billable hours—is spent on administrative and computer-related duties, such as digitizing massive files of patient records, as required by laws or insurance companies; seeking authorizations; teaching staff new workflows to accommodate new systems; and answering patient emails and phone calls.
The remarkable rate of change our industry has undergone in recent years is largely to blame. Over the past two decades, the healthcare industry has become increasingly governed by insurance companies and complex billing and payment systems, federal and legal mandates, the pharmaceutical industry, and technology that was intended to improve the business of care. The technologies that were created to help us—those that are likely woven into practices—are often already outdated, they are time-consuming, and too complex. They contribute to doctors feeling run down, tired and unfulfilled — not doing the jobs they were trained to do.
As a neurologist, I can illustrate the strain of administrative burden through a typical physician/patient scenario: Physician enters an exam room to see a patient with ongoing lower back pain, a carpenter who has been out of work for two months. Patient needs help to get back to work in order to support his family. Despite real empathy and a sense of responsibility for the patient, he is a follow-up visit—scheduled for 10 minutes—and is one of 20 patients the physician must see at a minimum that day.
In those 10 minutes, the provider must implement and discuss a care plan, evaluate and prescribe medication (ensuring there are no interactions with his current medications), and review therapy plans and possible procedure options. Simultaneously, he or she must deal with administrative burdens that include measuring the medico-legal aspects of care, checking off boxes in the EHR that prove all standards of care are being met, entering data into the EHR (takes more time than time spent with the patient), completing out-of-work documentation (takes an additional 10 minutes after documenting in the EHR), and ensuring prescribed medications are in formulary for patient’s insurance plan. A physician must do this as quickly as possible and repeat a minimum of 20 times per day. This is a fraction of some of the issues that are contributing to burnout.
Easing the Burn with Telemedicine
There is a lot being done to ease the strain on healthcare providers and create efficiencies to improve the practice of medicine. Hospitals and healthcare facilities offer stress reduction and wellness programs to help providers alleviate stress and promote better work-life balance. There are also several initiatives underway—led by healthcare providers, payers and pharmaceuticals, as well as the federal government—to reduce administrative requirements and burdens on physicians. Reducing stress and federal regulation requirements will certainly help combat burnout, as will embracing continued innovation. While technology is at least partially responsible for our current state, embracing the right technology—tools that prioritize our patient relationships and help us do the job we were meant to do—can certainly save us from those that create barriers and add to burnout.
For instance, telemedicine, the use of video-conferencing to communicate eye-to-eye with patients, enables physicians to leverage technology to add value to the most important part of a medical practice—seeing patients. Its use and interest among physicians across a broad range of specialties is surging. It’s for good reason, as use improves care and enables practitioners to spend more time with patients and to see more patients by offering virtual care for level 1-3 visits—for instance, helping a patient manage chronic conditions before they reach crisis level.
Consider, for instance, the patient scenario explored above. Rather than suffering back pain while waiting two months for a follow-up appointment with his doctor, the patient could have met with that physician via a 5-minute, reimbursable televisit, getting advice on activity level, exercise options, and alternative or complementary medication options that could speed his recovery, relieve his pain, and get him back to work.
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Televisits promote continuity of care by keeping patients connected with their own doctors, and maximize billable time through a built-in mechanism that monetizes after-hours care and communications like calls backs and follow-ups, helping providers operate more profitable practices.
According to the Medscape study, nearly half of physicians would take a salary reduction in exchange for more free time. They may be surprised to discover that the right technologies can help them create better balance, while also creating more lucrative practices.