Physician burnout – Who is going to budge?

Physician burnout is a hot topic these days. Here are the facts: according to the American Foundation for Suicide Prevention, the suicide rate among male physicians is 1.41 times higher than the general male population.

And among female physicians, it’s 2.27 times greater than the general female population. A 2016 survey by the Physicians Foundation revealed that 47 percent of U.S. physicians may retire sooner than planned. Whether it be the Centers for Medicare and Medicaid Services’ incentive programs, such as Meaningful Use or the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), electronic health records (EHRs), consolidation or liability risk, physicians are leaving their careers early, many times for their overall health.

How we got here
In the fee-for-service world, physicians used to treat patients based on their knowledge from medical school, continuing medical education courses, research and experience. Now, many physicians are forced to comply with standards in which they may not believe in order to get paid through the new fee-for-value model. Not only does this new model force physicians to follow guidelines set forth by the health insurance companies, it forces physicians to embrace EHRs, which also may not have been ready for the change.

EHR role
Many EHRs were developed as billing platforms and the clinical side was added later, thus giving the system an awkward feel to someone using it clinically. This has frustrated physicians and caused them to feel as if they were working for the system (developed by an IT guy) rather than the system working for them.

In addition, EHR vendors have struggled to keep up with new metrics from health insurance companies. Often these vendors release multiple versions of their software well before it is ready to meet new certifications. Smaller, more user-friendly applications are being sunset because there is no capital to invest in all the necessary changes to comply with payer requirements.

It takes a lot of money and a team of people who can dissect the new programs and metrics to constantly meet new certifications. It doesn’t help that, other than federal programs, each (commercial) incentive program is different. There is no chance an EHR vendor can set up each system perfectly for every single client across the country, which leaves it up to the health system, physician organization or independent clinic to ensure the EHR can collect and report quality data.

There is evidence of consolidation in the industry, most recently with the purchase of Practice Fusion by Allscripts. With increasing pressure on EHR companies to make the necessary changes, as well as consolidation driving down the ability to charge enough to make these changes, many clients are left with the technology but no understanding of how to use it. EHR vendors are marketing new features and technology and then relying on recorded webinars and manuals to teach users. This results in users not understanding the technology and thus not adopting it. It is a “no-win” situation for all involved.

The EHR vendors are pushing back saying additional training and many new features are worth the additional investment while clients believe it should be included with their maintenance and support package. In order for these features to be properly implemented and begin to help lessen the load on clinical staff, someone is going to have to bend. For example, the client could assign a staff member, with project management skills, to ensure the EHR is properly setup and implemented. This may also require hiring a consultant to ensure best practices are in place and the EHR is used effectively so each staff member is working to the top of their licensure.

Clinical staff role
Currently, physicians are asking their office managers to manage the EHR and many incentive programs. For the most part, office managers have a clinical background and may not understand how to manage a technology application or how to communicate what features and functions they need. This results in items slipping through the cracks or miscommunication with the EHR vendor on what metrics need to be tracked.

Staff going about their jobs as they always have is no longer acceptable as only those who can change will succeed. Many of those facing burnout are also rejecting change, as they go hand in hand. Clinics struggling with something today will likely be in the same position next year and the year after, until the physician sells to a hospital or retires.

What success looks like
Practices with few signs of burnout are those with strong leadership, the right skills, and have excellent communication with all staff. If staff understands why decisions are made, they are more likely to be on board and adopt the changes into their daily work life. Also, it makes sense to reach out to other strong leaders in the industry and/or consulting firms with experience working with similar clients to ensure decisions follow best practices. A strong office manager can take stress off the physician with the proper support.

To summarize, we are at a crossroads and physicians are suffering from burnout. Healthcare is going to continue to transition to a fee-for-value payment model and EHRs will remain at the center of the practice. The EHR is a tool, and it’s up to healthcare teams to make it work in their offices. It’s time to partner with your EHR vendor and select a strong office manager with the leadership skills necessary to take some work away from physicians.

There is an ongoing need for investment in training for all practice staff. Being at odds with your EHR and constantly complaining will not help you succeed. Partner with a consultant, with a proven track record, who understands how to make you successful. An EHR consultant can help redefine roles and map out processes resulting in improved quality performance and additional revenue, allowing physicians to leave the office much earlier to be with their families.

Author bio for Chad Anguilm
Chad Anguilm has more than a decade of practice operations and workflow management experience. Throughout his career, he has leveraged practical expertise to bring relevant, effective, new and lasting solutions to health care and business challenges. As director of In-Practice Technology Services at Medical Advantage Group, he oversees electronic health record (EHR) implementation teams and provides vital practice consultation to optimize systems. With a unique combination of technical and interpersonal skills, he analyzes practices to gain a thorough understanding of processes from the inside out. Utilizing his extensive understanding of EHRs, streamlining clinical workflows, Meaningful Use, HIPAA, interoperability, and health care forecasting, he identifies inefficiencies and develops multi-faceted solutions to enhance practice operations and, ultimately, to enhance overall patient care and reimbursement.

Editorial contact
Katie Searl
Marketing Writer
Medical Advantage Group
517.336.1441 or

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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