'There's a bunch of sludge': How efficiency can keep physicians happy

Technology is meant to make things easier, but "it's a great irony that when we were on paper charts, things were more efficient," Doug Bruce, MD, chief clinical integration officer at Cleveland-based MetroHealth, recently told Becker's.

In the days of paper charts, physicians wrote only a quick paragraph, but now physicians have to answer many other questions or address pop-ups or click multiple things. There is an increased burden on providers that has slowed care down, Dr. Bruce said. Many physicians are reducing their hours due to an inefficient system that places too much burden on them.  

"It can be a slog and if I'm slogging through this, I need some space to clear my mind," Dr. Bruce said. "My concern is things keep pushing into the world and people's response will be to continue to pull back from medicine. We need to find a proper balance where we say, 'How do we encourage the best behavior in all people at all times?'"

Dr. Bruce said it comes down to efficiency. 

"I worry that we're not teaching people to be as efficient as they could be and that we're not supporting people to be maximally efficient," he said. "There's a bunch of sludge in all systems and some creeping in due to regulatory requirements. We don't want to keep adding complexity in medicine. The only out a provider gets is to say, 'Decrease my hours.' We need to find a way to most efficiently address requirements, a better way to do this work so we can support providers to stay in the environment."

Improving efficiency can keep people in the field.

"One of the fun things about medicine is it tends to bring together people who are really skilled at lots of things," Dr. Bruce said. "We don't ever want to be so rigid in healthcare where we say, 'Well, it's an all-or-nothing thing here.' We want to make sure that there's no institutional barrier to people working maximum. Some people will still cut back their hours so they can pursue their other passions, but I don't want people to feel pushed out of medicine because it's so complicated or the operational structure or the grind that does not bring joy. Those are the things we have to fix. If someone says, 'I'm going to reduce my hours to pursue this other thing that helps me flourish,' then we can celebrate rather than mourn over the people who say, 'I can't take it anymore.'"

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