Using Technology Tools to Improve Doctor Work-Life Balance
There is a silent epidemic which is slowly spreading its way through the medical community – physician burnout. While we may hear reports of superstar athletes or movie stars who say they need a break because they are burned out, perhaps none has such life and death consequences as that of the physician.
Today’s doctors combat stress from every imaginable angle. They need to carry a heavy patient load to cover their overheads costs, pay steep malpractice insurance premiums, and still make a profit. Insurance companies require mounds of paperwork to document and support claims, and seem to fight the physician’s medical choices at every turn. The government has added even more layers of stress with new mandates requiring improved chronic care management, patient engagement requirements, and timeline adaptations to the Promoting Interoperability (PI) Program, all in the name of quickly transitioning to a value-based healthcare system.
All of that is certainly enough to create physician burnout on its own, as doctors spend increasing amounts of time at the office in an effort to keep the practice afloat and still provide quality care. The idea of being able to take any kind of break to recharge their physical and emotional well-being is impossible to imagine. Electronic technology and digital devices now make it possible for the office to follow the physician virtually anywhere on earth.
Instead of maintaining a healthy work-life balance, modifications are made to the daily schedule – often at the expense of quality family time, vacation days, personal health, and even emotional well-being. Disturbing statistics about the impact of these increased stress levels can be found in the Medscape National Physician Burnout, Depression & Suicide Report 2019. A survey of over 15,000 physicians from 29 specialties revealed that 44% reported feeling burned out. 11% experienced symptoms of depression, with 4% diagnosed as clinically depressed.
Some of the highest rates of burnout were reported in the specialties of urology, neurology, internal medicine, family medicine, and OB/GYN. Perhaps somewhat surprising is the fact that the 2018 report indicated that the highest levels of both depression and burnout were found in OB/GYN, urology, neurology and family medicine practitioners. For a profession that is founded on the principles of helping others feel better, it is highly ironic that so many of its own members are not up to par themselves.
These feelings most assuredly affect the ability to interact with patients at the highest levels on any kind of consistent basis. The doctor might appear less friendly or less engaging as the patient is trying to explain symptoms. It may be hard to focus on the conversation, document the symptoms, order the proper diagnostic tests, make an accurate diagnosis, develop a care plan, and log all of this correctly into the patient chart. Other disturbing symptoms of physician burnout include:
- Negativity or indifference toward patient care.
- Increased likelihood of medical care errors.
- Heightened feelings of cynicism or apathy.
- Looking at patients as a disease or a condition, and not as a person.
- Feeling of being on a treadmill without accomplishing anything.
- Becoming emotionally exhausted and withdrawn.
- Increased distance from partners, family members, friends and emotional support network.
Reducing Office Stress to Reduce Physician Burnout
Not only can physician burnout compromise the quality of care provided to patients and increase the possibility of medical
malpractice lawsuits, it also impacts the doctor’s ability to interact with office staff and other medical professionals. In response to these pressures, some physicians choose to take the hospitalist route, merge their practice with a larger organization, or leave the medical field entirely. In the worst case scenario, some 14% of doctors report thinking about suicide, with an estimated 400 physicians per year completing the deed.
To prevent these dire outcomes, it is helpful to understand the basic causes of office stress and to look at some ways of reducing it in order to avoid physician burnout. Medscape found that the factors which contributed most to feelings of physician burnout included:
Too Many Bureaucratic Tasks
This includes charting and paperwork. Over 50% of the respondents felt that this was the number one factor contributing to their burnout.
Trying to Accomplish Too Much
Overexerting yourself leads to spending too many hours at work. Conversely, this would also mean that the physicians are not spending enough time on leisure and non-work activities that could help reduce feelings of stress.
Implementing Electronic Health Records
An unforeseen consequence of the computer age is the fact that something as seemingly helpful as implementing EHRs is often seen as a contributing factor in burnout. Perhaps this is because it is mandated from government sources, or doctors are uncomfortable with computer technology. Finding the most efficient system for a practice’s needs can be difficult, and learning how to use a non-intuitive system can increase anxiety.
Perceived Lack of Respect
In older days, the physician was the final word in all medical situations. In the digital age, every patient can become a diagnostic sleuth, sometimes coming up with unlikely medical scenarios or challenging the doctor’s integrity on matters of cost.
Lack of Autonomy
While a private practice physician may have a good deal of autonomy about office protocols, many still feel bound by insurance company and governmental regulations. Physicians in a multiple-provider or hospital setting often report far lower levels of control.
Increased Regulatory Environment
This isn’t as high up as one might think, but it is still a great source of stress. Just between 2011 and 2014 alone, physicians had to deal with multiple events that had a huge impact on the medical industry including increased purchases of medical groups by hospitals, steep increases in drug prices, the Affordable Care Act and its ever-changing directives, pay for performance, and mandated electronic health records (EHRs). It seems like regulations change every year, and each practice must scramble to keep up or face penalties for non-compliance.
The Profit Motive
Profits are usually more central to practice protocols in multi-partner or hospital settings, but profit can still be a worry for the private practitioner as well. If he/she cannot run the office in a method that is conducive to earning money, the practice may ultimately be faced with closure.
To reduce the dilemma of physician burnout and restore a better balance, positive actions physicians can take include trying to exercise more, spending time with family and friends, listening to music, practicing higher levels of self-care or participating in some type of therapy. In your daily or weekly calendar, be sure to schedule in time for important family events or time with your partner. This makes it a priority, and having it in the schedule makes it more likely to happen. If someone asks you to do something that is in conflict with your self-allotted time, learn the art of saying “no” with firmness and grace.
Using Technology Tools to Improve Doctor Work-Life Balance
Although technology is currently receiving some of the blame for increasing physician burnout, it also has the opportunity of being able to restore the work-life balance as well by helping to organize, analyze and manage the practice. New advances are being made in technology every day which can help doctors realize that they can significantly reduce their paperwork and overhead time, so they can focus more on providing quality patient care.
A more text-based EMR such as Amazing Charts, and charting using dictation software like Dragon now allows practitioners to significantly decrease the time it takes to complete encounter notes, all while still meeting the guidelines and requirements needed to maximize billing. Technology tips to reduce administrative burdens include:
Practice Management Tools
Find a practice management solution that lets you manage patient records, insurance eligibility, documents, and billing, with tools that can save your practice time and money.
Population Health Tools
These tools allow you to aggregate, analyze, and achieve results for your practice as a whole through better patient care, reduced patient costs, and increased practice productivity.
Electronic Health Records are now more of a must for efficient practice management than ever before, but they do not have to add to the stress levels. Look for an EHR system with a high degree of intuitive menus, one-click access, and plenty of templates so you don’t have to input the same information over and over.
A telemedicine solution allows you to remotely deliver in-home patient care. A tool featuring secure video chat and text conversations allows you to continuously treat patients without the need for in-person contact.
The EHR has eliminated the need for cumbersome dictation and transcription routines. Dictation technology like Dragon makes it fast and easy to complete your charts and move on to the next patient.
Get On the E-Prescription Train
If you are still using a prescription pad and written instructions to provide prescriptions to your patients, you are causing unnecessary stress for yourself. E-prescribing gets your specific instructions directly to the pharmacy or dispensary and lets you get the exact medication to your patients more quickly.
Increase Electronic Communications
Recent advances in patient portals allow physicians to stop relying on the telephone to contact patients, exchange messages and share information. Intra-office messaging can be enhanced to allow charts to be instantly accessible and editable to any office user with appropriate access. Interoperability requirements can be met through electronic means instead of having to copy and mail vast quantities of paperwork.
Simplify Your Billing Structure
Let an electronic Revenue Cycle Management service handle the hassle of patient billing for you. 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.
Most medical schools do not have courses in self-care, burnout, and work-life balance, even though it might be a good idea. The onus, therefore, is on the physician to learn about the mindset, tools and technology which can help to run the practice in a better manner so the physician can lead his or her best life as well. Become your own wellness champion, and you will be a better champion for your patients.