It may be a very long time before we are able to fully assess the mental, financial and physical fall-out from the COVID-19 pandemic in the healthcare profession. Anecdotal stories have run rampant in the media and medical journals about providers who contracted COVID themselves from working with patients, and those who suffered the emotional toll of losing so many patients to this disease.
While those in independent practice might not have seen action on the very front lines, they suffered nonetheless. Becker Hospital Review reported that primary care physicians (66 percent) were more likely to experience burnout than specialists (59 percent). Doctors watched helplessly as their practices were restricted from seeing patients. They tried to make up the difference in patient care with telehealth and remote care but found it difficult to keep full staffing levels and cover the costs of maintaining an empty office, while witnessing a precipitous decline in income.
In March 2021, the National Institute for Health Care Management (NIHCM) Foundation called physician burnout and moral injury “The Hidden Health Care Crisis.” It reported that 76 percent of health care workers, especially those in the hands-on hospital medical care categories, were reporting exhaustion and burnout.
Medical specialties which exhibited the highest percentage of burnout were critical care, rheumatology, infectious disease, urology and pulmonary medicine. One of the top causes of physician burnout was listed as “moral injury.” This describes the feeling of knowing that patients do need medical care but being unable to provide it due to constraints beyond your control. Moral injury and burnout result in physicians becoming more likely to quit their jobs. As a result, their patients may have worse outcomes. Actions the NIHCM prescribed to reduce physician burnout and moral injury include:
One: Enable Technology Solutions
- Invest in a streamlined EMR system
- Provide more comprehensive training on the system
- Hire scribes to alleviate charting headaches
Two: Reduce Administrative Burdens
- Use telemedicine technology
- Increase staff responsibility
Three: Modify the Work Schedule
- Implement work-hour limitations
- Increase schedule flexibility
Four: Encourage Self-Care
- Learn stress reduction and mindfulness techniques
- Remove barriers to seeking mental health services
In October 2021, RevCycleIntelligence reported that, “Healthcare appears to be the sector most impacted by the ‘Great Resignation’ of 2021, but COVID-19 isn’t the only driver – physician burnout from healthcare system issues persists.”
It has been a difficult time, indeed, but many providers in private practice have managed to successfully navigate the turbulent waters of COVID-19. Technology, when used efficiently, can help to alleviate some of the administrative burdens of running a practice. On a larger scale, Health Affairs Journal has compiled some recommendations for Practice and Policy Reset Post-COVID-19.
Organizational Steps to Address Physician Burnout
Mayo Clinic published a study entitled, “Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systemic Review,” which found that the source of burnout more typically comes from factors on the system and organizational levels. It states that interventions which focus on alterations to the system rather than the individual physicians can be potentially more effective at reducing burnout.
One of the key interventions cited was the use of technology to solve physician burnout. Interventions which involve improvements to an EHR system have the capability of resulting in drastic improvements in physician burnout and satisfaction levels. This might be traced to the increased administrative efficiency created by the EHR, or the improvements in communication capabilities with staff and patients.
In another Mayo Clinic article, organizational strategies to promote engagement and reduce burnout include:
Strategy 1: Acknowledge and Assess the Problem
As with any problem, the first step is acknowledging that it actually exists. For your independent practice, this means a self-assessment or a discussion with staff about the effects of pressure on their ability to perform their jobs. Listen to the input that is provided and target the main causes of stress and frustration. Look at what is critical to your mission as a private practice and assess factors such as patient volume, patient satisfaction, quality of care, and financial performance. The health of the lead provider is critically important to the practice’s long-term viability.
Strategy 2: Harness the Power of Leadership
Although a good portion of the responsibility for the success of a private practice falls on the physician, it is important for that provider to cultivate a sense of leadership among others within the organization. This alleviates pressure on the primary provider and instills a sense of ownership in others. Look at your team members, and focus on individuals with the ability to learn, listen, engage and lead. Give them education, support and the flexibility to carry out some of the duties you would otherwise manage yourself. By distributing leadership tasks more equitably, you will give yourself more time to focus on the joys of being a healer.
Strategy 3: Look for Signs of Burnout
Learn the critical signs of burnout and look for them in yourself and members of your staff. Symptoms of burnout include:
- Emotional exhaustion, leading to easily becoming irritable or downhearted.
- Replacement of usual empathy with cynicism, negativity, and a feeling of emotional numbness.
- A low sense of professional effectiveness.
Strategy 4: Cultivate Community
A key indicator of burnout is withdrawal. The best way to combat this is to build a sense of community at work and within your social circles. Form networking groups with other physicians to discuss your unique challenges and share solutions. Within your practice, build unity among team members to find ways to minimize the most frustrating aspects of day-to-day activity. Celebrate achievements and support each other through the difficult times you experience. You can also look for ways outside the confines of practice routines to find improved meaning in work and your personal life.
Strategy 5: Use Rewards and Incentives Wisely
While there is a definite motivating factor in rewards, you do not want them to become expected, as they will lose their effectiveness. Team members should be expected to perform certain activities as a regular part of their job, and only receive rewards for going above and beyond normal expectations. Tying incentives to productivity can backfire, as the increased level of work may not be sustained once the rewards have been removed. Some incentives might not even be appealing to certain people, so be very careful to work with your team to identify quantifiable areas of improvement and discuss desirable methods of reward. Incentives such as workplace flexibility or education opportunities can sometimes be more motivating than tangible items. Balance the risk/reward of a goal such as “increase the number of patients seen every day” with its impact on the quality of care provided and the increased stress it may inflict on your team. You don’t want a reward designed to reduce burnout to actually become the source of increased performance angst.
Strategy 6: Align Values and Strengthen Culture
The overriding goal of your private practice is to provide the best possible medical care to patients. Be mindful of how your decisions about reducing burnout might affect your mission statement. Ask your team to help evaluate how well you are meeting your healthcare goals and identify ways to improve your visibility in the office and in your community. Share the values often through meetings and signage, to remind staff members of what is most important.
Strategy 7: Promote Flexibility and Work-Life Integration
Look at your own policies to determine their ability to increase burnout. Give yourself the flexibility to adapt your daily schedule, so you can build a better work-life balance. Having a successful practice can be moot if you do not take the time to enjoy the fruits of your labor. Use technology and your team to make your private practice run smoothly, and you will be able to focus on what is important to you in other aspects of life. Involve your team in finding ways to address practice issues that affect the work-life balance for everyone.
Strategy 8: Provide Resources to Promote Resilience and Self-Care
Show that you are serious about self-care by creating a healthy culture within your independent practice. Allow yourself and team members to talk about issues without recrimination, have coping mechanisms available, offer educational materials, and include mental health resources to promote well-being.
Wellness Strategies to Reduce Provider Burnout
Provider burnout is not something new that has come about just because of COVID. It has always existed but has been exacerbated by the length and intensity of the COVID pandemic. Even though it is wide-spread, you do not have to become susceptible. The AMA recommends seven steps to prevent physician burnout:
- Make wellness a quality indicator for your practice.
- Start a wellness committee and/or choose a wellness champion.
- Conduct an annual wellness survey.
- Meet regularly with leaders and/or team members to discuss data and interventions to promote well-being.
- Initiate selected interventions.
- Repeat the wellness survey every year.
- Seek answers within the data, refine the interventions, and continue to make improvements
AMA also provided steps to improve personal wellness. This starts by taking a comprehensive inventory of personal needs. Then spend 30 days checking in daily with the following parameters to measure progress. Keep notes to stay accountable to yourself:
- Think About Your Physical State
- Think About Your Mental State
- Connect Socially
- Find Meaning In and Outside of Work
- Embrace Joy
- Reflect and Refine
Enable Technology Solutions to Reduce Physician Burnout
According to the American Medical Association (AMA), challenges with health information technologies can affect professional well-being. These problems include difficulty using the health IT tools, poor integration into clinical workflow, and problems sharing information among team members. It recommends that those in the industry work closely together to solve these challenges.
On the vendor side, Amazing Charts is constantly looking for ways to ease the burden on health care providers. Our system was built by a physician, for physicians. Some ways we can help improve the efficiency of your private practice include:
Electronic Health Records (EHR)
We integrated EHR capabilities that make smoother charting a breeze. Components of our latest comprehensive EHR systems include easy charting capabilities and templates to maximize provider time, e-Prescribing, better scheduling capabilities, and a patient portal for enhanced communication purposes.
Telehealth solutions will continue to increase the ability of your practice to remotely deliver in-home patient care that is comparable to an in-office visit. You and your medical staff can quickly and easily initiate telehealth video and secure text conversations and maintain logs of those chats and videos for billing and audit purposes.
Virtual Preventative Care Assistant
Another advancement that is helping to bring a better work-life balance to private practice is a Virtual Preventative Care Assistant. Amazing Charts now offers the capability to add external remote care services to your patient care kit by adding remote staff, or contracting out existing staff, to reduce labor costs while maintaining patient continuity. This takes a huge administrative burden off of the medical professional.
Medical Billing Service
The area that can cause a lot of administrative stress for your medical office is coding, billing and collections. Amazing Charts Medical Billing Service is a fully integrated Revenue Cycle Management service that handles the hassle of billing for you, and at a more affordable rate than most third-party billers. Your practice could experience an increase in collections, a higher rate of claims paid on first submission, and a quicker time to payment with your payers and patients.
Healthcare Technology Solutions Designed By and For Independent Practices
Amazing Charts was founded in 2001 by a practicing family physician to help medical practices thrive. We have grown consistently since then by creating easy-to-use solutions for delivering patient care. Today, we offer a variety of additional capabilities designed to help independent practices succeed, including Electronic Health Records, Practice Management, Billing Services, Population Health and Remote Care. Call 866-382-5932 to learn about our products, schedule a practice consultation, and learn more about telehealth pandemic lessons that can help your independent practice grow.