Flying home recently from an industry trade show, I sat next to a woman in her early 60s travelling to New Hampshire to visit her daughter who was getting married in a few months. She lives in the Midwest and explained it was her first time to New Hampshire. We chatted for a bit and she asked me what I did for a living. I talked about my work at Geneia and how our organization focuses on using data, technology and analytics to help providers, health systems, health plans and employers more easily collaborate to deliver personalized care and improved health. This struck a chord with her.
She told me she was a pediatrician who had practiced independently for most of her career. Given the increasing challenges of operating independently and nearing the end of her practice at 62 years old, she decided to close her doors and joined a larger medical group, which was then shortly thereafter acquired by a large health system.
It was after that when she became really frustrated and decided this wasn’t for her. She was spending too much time on administrative tasks and paperwork. She felt patient care was suffering and she didn’t feel like she could give her patients the time and attention they needed. She was doing more but feeling less effective.
Fortunately, instead of giving up practice altogether, she found a small community health center where she could practice three days per week and have more flexibility. “I feel better about taking care of my patients,” she said.
We chatted a little more about the challenges in today’s healthcare system and the widespread rates of physician burnout. In the end, she said simply: “Well, good luck to you. I hope you solve it.”
A relationship based on trust
Our vision for the future healthcare ecosystem is that all patients have a meaningful and trusted relationship with a physician and care team who are inspired and find joy in the practice of medicine. This is the main reason we focus so much on the issue of physician burnout and seek ways to restore the Joy of Medicine to practice. The consequences of increasing burnout and frustration not only erode the trusted patient-physician relationship, but can also be dire.
Most are probably aware of the recent poll of 6,700 clinic and hospital physicians that showed more than half are burned out and more likely to make medical errors. In fact, 10 percent admitted committing at least one significant medical mistake in the three months leading up to the survey.
A Medscape survey reported at the beginning of this year the impact physician burnout can have on patients:
- Two-thirds of doctors reporting feeling depressed, burned out or both
- One in three depressed doctors are easily exasperated by patients
- 32 percent were less engaged with their patients
- 29 percent acknowledged being less friendly
Geneia’s own survey conducted three years ago, which led to the creation of the Physician Misery Index, revealed similar findings.
- 67 percent of all surveyed doctors know a physician likely to quit practice in the next five years because of burnout
- 78 percent say they frequently feel rushed when seeing patients
- 87 percent say the “business and regulation of healthcare” has changed the practice of medicine for the worse
Quality reporting is one of many factors impacting burnout
I recall a doctor’s appointment I had not that long ago. The medical assistant sat in front of his computer, asking me questions and inputting information while exhaling occasionally in frustration, punching the keyboard with his fingertips and lamenting the amount of documentation and computer work he had these days.
Indeed the quality reporting requirements for physicians are enormous and burdensome, with physicians now tracked on more than 2,500 performance measures, the majority of which have been implemented in the past 30 years.
However, according to a recent New England Journal of Medicine study:
“The fact that just 37 percent of measures proposed for a national value-based purchasing program were found to be valid using a standardized method has implications for physician-level performance measurement. The use of flawed measures is not only frustrating to physicians but potentially harmful to patients. Moreover, such activities introduce inefficiencies and administrative costs into a health system widely regarded as too expensive already."
Physicians claim that complying with quality measure reporting costs about $15.4 billion per year, or $40,000 per physician.
Technology more broadly contributes to higher levels of burnout and lower levels of patient safety and quality of care. While the HITECH Act was meant to help health systems implement electronic health records and better document care being provided, it didn’t bring about the standardization needed. The result is a patchwork EHR environment with different interpretations of Meaningful Use and a lack of interoperability that often increases the burden and frustration of physicians who must use multiple systems.
It’s everyone’s problem to solve.
I’m sure the doctor I sat next to on the plane meant “you” in a general sense when she said “I hope you solve it.” Because Geneia certainly can’t solve it alone. Nor can any one organization or entity for that matter.
For our vision of personalized, patient-centered care and a restored Joy of Medicine to become reality, all healthcare organizations and stakeholders – physicians, hospitals, healthcare delivery networks, payers, employers, patients and families – must work together to address these factors that we know lead to physician burnout, poorer outcomes and higher cost.
At Geneia, we use technology and insights to help organizations better collaborate and align so they can better support a healthy patient-physician relationship and ultimately improved health for all of us.