Viewpoint: Physician, nurse turf wars must end to effectively reduce EHR burden  

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While physicians and nurses may have a history of not always seeing eye to eye, both professions share a common issue central to their workflows: burnout associated with EHRs, according to a Dec. 31 New York Times op-ed.  

Despite their original intention to help improve clinical workflows and save time, widespread adoption of EHRs has arguably done just the opposite, causing physicians and nurses on average to spend at least half of their workday fulfilling documentation requirements, according to Theresa Brown and Stephen Bergman, MD. This increase in screen time associated with EHRs, as well as physicians' need to finish documentation work from home, has fueled clinician burnout.

While EHR-associated burnout levels among physicians and nurses are rising, there has been a stark amount of inaction for change, Ms. Brown and Dr. Bergman wrote. "…Not enough clinicians are making it loud and clear that change is necessary. Doing so requires a unified voice across our professions — and unfortunately, right now, doctors and nurses are anything but unified."

Ms. Brown, a clinical faculty member at the University of Pittsburgh School of Nursing, and Dr. Bergman, a medical professor at New York University, attribute the physician-nurse pay gap and physicians' higher status in the medical hierarchy as driving factors for the professions' lack of unity to address EHR burdens. The op-ed authors argued that the experience of nurses is "often invisible to physicians," which propels the medical hierarchy and prevents the groups from tackling common issues.

As hospitals and insurance companies require physicians to provide more and more data to support payments and billing, clinicians are tasked with inputting much more patient information into the EHR than ever before. The authors wrote that healthcare organizations should institute documentation requirements similar to those of the Department of Veterans Affairs, which requires clinicians to document information relevant to delivering better patient care rather than focusing on billing concerns.

Physicians, who generally have little experience with activism on workplace issues, should enlist the help of their nurse peers in organizing EHR change, the authors concluded. Nurses have spearheaded improvements for hospital working conditions through groups such as National Nurses United, which represents nurses across the country.

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