Physician burnout is an epidemic in the U.S. and it’s taking a toll on the country’s healthcare system. The root cause of physician burnout is a collection of factors that are unique to physicians. Some of these can be fixed by physicians themselves, while others require an entire health system’s attention to remedy; however, none of them ought to be ignored.
Physician burden is a term used to describe the frustration that physicians experience in patient care, being frustrated in dealing with the complexities of administrative requirements from health insurers, quality oversight of their work, and the latest electronic health records complexities. This doesn’t even address the people issues, like dealing with factors related to other hospital staff and other physicians. Enclosed are three of the biggest drivers of today’s physician burden and some key insights on how they can be addressed.
Workflow Disruption
The first step to addressing physician burden is understanding its impact on workflows. In particular, physicians are required to spend over 50% of their time managing their electronic health record (EHR) tasks instead of seeing patients. This results from workflow disruption caused by a variety of factors, including new regulations requiring physician feedback for relevant cases, policies such as patient safety improvement, and general EHR usability issues.
According to a recent report by Deloitte, the average physician spends about 30 hours per week on nonclinical tasks — an increase of over 50 percent since 2011. The study also found that physicians spend more than twice as much time on documentation as they did 10 years ago. That’s not surprising given that most physicians are employed by large ($Billion revenues annually) hospital systems, and are required by contract to spend their time within the EHRs administrative and clinical tasks, which require more documentation than ever before.
Physicians now spend a significant amount of their day dealing with non-clinical tasks such as entering data into EHRs, updating software, answering emails and phone calls from insurance companies and pharmacies, making referrals, and other administrative tasks.
These activities are critical to patient care and require physicians’ attention if they want to avoid quality deficits in their record, and paychecks that bounce because of missing all of their revenue cycle queries. In addition, there are often too few people available to help physicians respond quickly to requests for information from outside sources like insurance companies or Medicare/Medicaid audits. The physician is the cornerstone of all decision-making in healthcare and no matter how many nurses, technicians and other staff surrounding them, they bear the final responsibility in care decisions.
Death by Manual Processes
For most physicians, the burden of manual administrative tasks is a constant source of frustration, such as paperwork and phone calls.
On the one hand, we’re seeing unprecedented growth in new technologies that promise to reduce paperwork and increase efficiency (e.g., electronic health records). On the other hand, we’re seeing an uptick in regulatory requirements that will likely drive up administrative burdens (e.g., quality metrics and risk adjustment validation).
To help doctors manage these competing demands, they need to know where their time goes and why it’s being wasted. In fact, according to a recent HIMSS survey, doctors are more interested in changing their workflow than in any other aspect of their job.
Conflicting demands from multiple stakeholders
Physicians today are facing an unprecedented amount of demand, with a growing number of sources and types of pressure.
Patients expect more from their doctors today than ever before. They want them to provide access via email and phone calls, respond quickly and efficiently with accurate prognosis and treatments, treat chronic diseases like diabetes and hypertension proactively, prescribe medications and their refills electronically, and make referrals to specialists when needed.
Continuing Medical Education is an important requirement for board certification and ensuring enough time for professional development — When physicians aren’t able to keep up with new medical knowledge or training opportunities, they feel unprepared for their jobs or even embarrassed by their lack of knowledge compared with their peers and now patients due to the explosion of medical knowledge available on the internet.
In addition, there are new regulations and requirements for physicians in every specialty — from primary care to surgery — that make it difficult for doctors to focus on what matters most: their patients’ health outcomes and the physicians’ quality of life. Physicians must comply with hundreds of rules and regulations set forth by federal agencies such as Medicare, Medicaid, and The Joint Commission (TJC).
Innovating Within the Box
EHRs are here to stay, and the best way to innovate with them is to think inside the box. EHRs like Epic are not start up companies any more and require a thoughtful software development process to upgrade them, and that’s a good thing. That’s why we built HITEKS CAPD360 Insight platform: to help you innovate within the box, not outside it.
In May, 2022, HITEKS CAPD360 Insight became the only service powering Epic’s latest “Analyze Note” Editor. The service is embedded within EHR workflows, making it the most compliant source for completing documentation for quality diagnoses and fair reimbursement. It’s usable with the EHR so that you can fix clinical notes at the point-of-care without delays—and that makes all the difference when it comes to strengthening your reputation and protecting revenue. Improve your rankings by getting ahead of your peers in terms of compliance with regulations like ICD-10 and CJR.
The industry is changing, and we’re working to stay ahead of the curve. We’ve found that by innovating inside of the box, we can deliver a better product—one that’s compliant with EHR workflows and also usable by physicians who want to spend more time on patient care instead of navigating their computer system. While CDI query tasks used to take many hours per week to complete, on average, HITEKS now prides itself on helping physicians reduce their CDI hours by over 50%.
Takeaways and Closing Thoughts
While there may not be a silver bullet to eradicating physician burden, health systems can make investments that target these drivers, beginning the process of reducing their physicians’ tasks with respect to retrospective, administrative duties which can best be accomplished in real-time while the patient facts are still top of mind. Reducing the burden on physicians is a critical consideration for health systems in the era of value-based care. As competition increases between providers and health systems, provider efficiency will become an even more important factor.
By understanding the range of physician burden drivers and their impact, health systems can deploy appropriate solutions that reduce their burden. They can also monitor, measure, adjust and maintain progress.
In order to maximize its potential to reduce physician burden, a health system will need to study its own drivers, understand the motivations that drive physicians and develop methods of directly addressing those drivers. It will be fairly simple for an individual health system to target these three areas; however, we recommend that all health systems do so because they are necessary to achieve financial and quality success.
In the end, your efforts to reduce physician burden will likely focus on three things: building and adapting a culture that values the physician’s judgment and autonomy, improving your technology by leveraging best practices and evidence-based decision-support, and finally, revisiting some of the goals you set at the beginning of this process. All three are equally important, but they are the core components you must focus on in order to be successful in reducing physician burden.