So reads the headline from a Fierce Healthcare article about the findings in Medscape’s 2017 Physician Lifestyle Survey.
The article goes on to report that physician burnout - which Medscape only began including in its survey four years ago - has increased from 40 percent in 2013 to 51 percent today. At 55 percent, the burnout rate is even higher for family and internal medicine physicians.
Without a doubt, these are alarming and troubling statistics, ones that should concern all of us who work in healthcare, and patients too. But I’ll confess I’m not at all surprised.
Given the conversations I’ve had with physicians around the country in the past few months and what they’re expected to accomplish in each patient visit, I’m amazed the burnout numbers aren’t even higher.
It’s quite possible my view also may be colored by the large number of physicians and healthcare leaders who heralded Geneia’s publication of the Physician Misery Index in 2015.
Geneia’s Physician Misery Index
To refresh your memory, Geneia surveyed more than 400 physicians practicing full time and found widespread physician burnout and a nationwide Physician Misery Index of 3.7 out of 5, indicating the scales had tipped towards dissatisfaction. The survey also revealed:
- Two-thirds (67 percent) of all surveyed doctors knew a physician who was likely to stop practicing medicine in the next five years, as the result of physician burnout.
- An overwhelming majority – 87 percent – said that the “business and regulation of healthcare” has changed the practice of medicine for the worse.
- 84 percent believe quality patient time may be a thing of the past
- 78 percent of doctors said they frequently feel rushed when seeing patients
Likewise, I suspect most patients frequently feel rushed when seeing their physician, especially as I’ve heard more doctors have had no choice but to tell their patients, “I can only focus on one issue during this visit.” When I think about all physicians are asked to accomplish in a typical patient visit, it’s easy for me to understand why everyone involved feels hurried.
It seems to me the heart of the doctor – patient relationship is rooted in patient visits, and I suspect the problem and the solution may lie in looking at patient visits in more detail. After all, for most physicians, the ability to create meaningful relationships with their patients and truly impact health outcomes is why they entered the practice of medicine in the first place, and therefore is critical to experiencing joy in their work. Similarly, when I talk with patients, they too want a strong relationship with their physician, even more so when they’re experiencing illness.
Physicians and Patients Feel Rushed
According to Medscape’s 2017 Physician Compensation Report, most physicians (59 percent) spend between 13 and 24 minutes with each patient. So that means the average visit is about 19 minutes, which is consistent with research published in the American Journal of Managed Care showing the average visit duration increased from 19.9 minutes in 1993 to 20.3 minutes in 2010. Additional research led by Christine Sinsky, MD, Vice President of Professional Satisfaction at the American Medical Association found that only 52.9 percent of visit – about 10 minutes - is dedicated to talking to or examining patients. At 37.0 percent, desk work and documentation in the electronic health record (EHR) accounts for more than a third of time during an average patient visit.
Yet, there is ever-expanding list of things for the physician to do during the 10 minutes of patient interaction and examination:
- Greet the patient.
- Ask the patient why he or she has come into the office. Potentially engage in a dialogue about a chronic or recurring illness such as obesity, diabetes or asthma.
- Exam the patient, which likely begins with the physician washing his or her hands and depending on the reason for the visit, includes accessing and using medical equipment such as a stethoscope, a tongue depressor and/or ophthalmoscope. In many offices, measures such as weight and blood pressure will have been taken by the physician or medical assistant before the physician enters the room.
- Assess and diagnose the patient, many of whom have complex comorbidities and impactful social determinants of health.
- Communicate the diagnosis to patient (and perhaps to a caregiver or loved one too) and explain the treatment plan. Ensure the patient understands the diagnosis and next steps.
- Answer patient questions
- Get to know the patient. Create and maintain a relationship with him or her.
At the risk of stating the obvious, that’s a demanding and action-packed 10 minutes, and the physician needs to do this as many as 18 times a day. Every day. Never mind the internal and external pressure to correctly diagnosis each and every patient.
Is it any wonder physicians feel like they’re on a patient-to-patient treadmill and increasingly burned out?
What If Technology Had a Heart? At Geneia, It Does.
Even before we created the Physician Misery Index, at Geneia we started asking ourselves, “What if technology had a heart?”
In answering that question, we set out to create technology solutions to stop physician burnout and increase the satisfaction of physicians and their patients. We have always believed technology and analytics designed with physician input and to fit within the existing workflow can help restore the Joy of Medicine to physician practice.
- Physicians are a highly-valued, limited resource;
- The central tenant to design of workflows and tasks which involve physicians must be to minimize the overall effort expended by physicians;
- To the greatest extent possible, everything that can be done by someone other than a physician, in fact, should;
- That other administrative and care team members are perfectly equipped, if given the right information and tools, to identify risk, coordinate care, manage open care opportunities, close care and coding gaps, motivate and engage patients, and perform recordkeeping to maximize a return on quality, cost and revenue, and
- We must reserve physicians’ personal efforts for the patient relationship, diagnosis and treatment.
How Remote Patient Monitoring Helps Stop Physician Burnout
The Geneia @HomeSM remote patient monitoring program is perfect example. It’s a 24x7x365 solution that combines predictive analytics, state-of-the-art technology, and individualized clinical support to help chronically-ill patients as well as their physician and care team better understand, monitor and manage their health.
Beyond the hard facts of improved results, nearly all of the remote patient monitoring program happens outside of the doctor’s office, managed by a broader care team, and outside of the traditional patient visit. Yet the program and its daily transmission of a patient’s body weight, heart rate, blood pressure, blood oxygen rate and more from the patient’s home to his or her care team complements and enhances the care provided in the doctor’s office, leading to earlier intervention and the elimination of avoidable emergency department visits and hospitalizations.
The results of our 12-month scientific study show remote patient monitoring works. Specifically, we were able to:
- Slow Disease Progression: As measured by risk scores, the risk score of monitored patients increased 29 percent compared to an increase of 58 percent for the control group.
- Reduce Hospitalizations: Hospital admissions declined 76 percent for study participants and 31 percent for the control group.
- Lower Costs: Medical spend was 50 percent less for monitored patients.
- Increase Medication Adherence: Pharmacy costs increased 18 percent for monitored patients indicating a higher level of adherence to the care plan.
- Improve Patient Experience: Geneia @HomeSM program participants report an overall satisfaction rate of 96 percent.
Remote patient monitoring also results in more fruitful office visits for the physician and the patient. Rather than rely on patient recollections, accurate HomeSM program readings and health values are seamlessly integrated into the patient’s health record. They’re aggregated and actionable during and between patient visits.
Advanced Analytics: Technology with a Heart
Our Theon® analytics platform is another excellent example of our technology with a heart, where the right information and tools provided to care team members can, and does, reduce the burden on the physician. Just ask Dr. Jody Allen, who said,
“For the first time in more than a decade, I no longer feel shackled to my computer screen and I have enough time for all of my patients on most days.
It took some time to fully realize the benefits of the Theon® platform and reengineer our practices and care teams, but once we did, I found that I had regained 90 minutes a day – and that’s meant that I’ve been able to once again feel the Joy of Medicine.”
All of us need and want satisfied physicians like Dr. Allen who have time for meaningful doctor-patient relationships. That’s why those of us who work at Geneia are so passionate about solutions like the HomeSM remote patient monitoring program that effectively use technology to improve patient care as well as patient and physician satisfaction.