By Matt Lambert, M.D., Curation Health Chief Medical Officer and practicing ED physician
Recently, I had the opportunity to speak with Steve Waldren, CMIO of the AAFP and Mike Archuleta, CIO of Mt. San Rafael Hospital about the state of physician burnout on a panel with the E-Health Initiative. As a practicing physician, I am no stranger to burnout. I have seen colleagues struggle with an array of mental health issues only to hide them instead of seeking help for fear of repercussions.
The current state of “don’t ask, don’t tell” with physician mental health is dire on the heels of the pandemic. The critical nature of this situation and its impact on physicians and the patients they serve makes the need for leaders to step up even more pressing. Additionally, we discussed ways to not exacerbate burnout with poorly configured or implemented technology.
As part of my discussion with Steve and Mike, we explored what healthcare leaders can and should prioritize in the year ahead to ensure physicians have the transparency and support needed to deal with many of the taxing issues leading to burnout – from the latest impact of COVID-19 to longer-term struggles with administrative burdens brought on with things like the electronic health record and value-based care.
I left the conversation with Steve and Mike feeling energized because of the shared understanding of the problem at-hand, and the realization that this problem can only be solved when C-suite and physician leadership come to the table and chart a path forward together.
In order to properly address physician burnout on the heels of COVID-19, we agreed that there are a few specific areas where support is needed in the near-term.
Prioritizing a Care Team Approach – There’s No “I” in Team
First, patient care must be team-oriented. Putting the onus on physicians alone to drive high quality outcomes and manage all of the administrative duties of patient care is precisely why we have burnout issues today. We simply can’t ask more of physicians.
We agreed that a care team approach with the physician at the center is the appropriate model moving forward. This care team approach ensures physicians have the surround sound support they need to prioritize patient care, while also offering them resources so that they can better manage necessary changes like transitioning to value-based care and adopting new, emerging models of care like telehealth and remote patient monitoring.
Improving Technology and Striving to Make It User-Friendly
As a clinician, I can tell you the clerical burdens associated with patient care are significant. On top of that, the technology that physicians have been given – specifically electronic health records – were not made for value based care. Oftentimes we are asking providers to do something they were not trained to do, using a tool that was designed for something else.
Together, Steve, Mike and I discussed some of the emerging technologies that hold promise in reducing clerical burdens today. Technologies like artificial intelligence, machine learning and voice recognition all hold great promise. But the reality is that many are just not ready for prime time. More so, these technologies ask more of physicians – more time to learn how to use them and more changes in our current, established workflow. Physicians don’t have the time and energy to deal with this learning curve – especially today as we get back on our feet post COVID-19.
With this in mind, we agreed that there is a need to rethink the electronic health record (EHR) as the “center of the Universe.” Clearly, EHRs have been part of the problem versus the solution to physician burnout. As healthcare leadership plans ahead for changes to their technology stack, it will be important that they too rethink the role of the EHR. Until this technology catches up to what we are used to using in other parts of our lives, healthcare leadership needs to identify new technologies that address and help automate physician burdens like clinical documentation and charting – as well as platforms that can help deal with the massive patient data fragmentation we are experiencing today with EHRs.
Incenting the Right Changes
While there is some mistrust with the idea of incenting change based on lessons learned from the Meaningful Use push, the reality is that change won’t happen in healthcare without some sort of “carrot.” The key for healthcare leadership moving forward is to incent the right changes.
When we talk about the right changes, it is helpful to share an example. A solid change to incent is the move from giving physicians 10 minutes to see a patient and, instead, incenting and supporting them to take the time they need to fully address a patient’s health ailments and assess full risk in order to drive preventive, holistic care.
Another example of a smart change to incent is the transition to value-based care. This transition is challenging for healthcare leadership, and for physicians and care teams. With this in mind, a system of rewards for those physicians that embrace changes to value-based care – such as new approaches to clinical documentation that fit into current workflows but also align with prospective risk adjustment best practices – can go a long way to helping drive the changes necessary to embrace value over volume.
Aligning physician compensation models with value-based care has helped the organizations that I have worked with. Why? Changing the way physicians think and practice is not easy. If you want them to embrace yet another change – and one as mission-critical as operationalizing value-based care – physicians want to know what is in it for their patients. Incentives help ensure the right levers are pulled to make the transition a reality, and also offer physicians compensation for any additional work that is needed to put these changes into action.
As physicians, we are still surrounded by antiquated systems and technology. Changing this fact is not something that will happen overnight because these issues are deep-rooted and systemic. Still, with a sharp near-term focus by healthcare and physician leadership on these above three areas, we can make smart change a reality. Bringing joy back to the practice of medicine by addressing burnout head-on with these changes is what we all need in order to stabilize the future of patient care.
To learn more about reducing administrative burden and the transition to value-based care, read more about Curation Health’s Advisory Services.