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Preventing physician & staff burnout

Providers frequently work under the strain and pressure of balancing the cost of care, quality of care and patient satisfaction, which can create an increasing demand on their time and lead to physician burnout and nursing burnout.

However, with careful planning, administrators can help prevent burnout in their healthcare staff. One effective way to help is by reducing inefficiencies in the workplace.

Physician burnout is a real problem

In 2017, Medscape's Lifestyle Report measured physician burnout in 27 physician specialties, where all but one specialty (infectious disease) gave a four or higher rating based on a seven-point scale, where 1 equals no burnout and 7 equals severe burnout.1

An American Medical Association study from May 28 to Oct. 1, 2020, found that nearly half of 20,000 physicians surveyed suffered burnout, with stress scores also being high among nurses, staff and medical assistants.2

Unfortunately, physician burnout remains a significant issue in 2021. A survey from the Physicians Foundation found a burnout rate of 61% among physicians in 2021 compared to 40% in 2018.3

The impact of burnout can touch multiple areas of a practice, including provider retention, error rates, customer satisfaction and the organization's culture. It can even have a financial impact; cost estimates for replacing a physician are between $500,000 to $1,000,000.4

Not surprisingly, the Medscape study identified these four areas as the top causes of burnout:

  • Too many bureaucratic tasks
  • Feeling like just another cog in a wheel
  • Increased computerization of practice
  • Spending too many hours at work

We spoke with Jeffrey Norris, MD, chief medical officer at Father Joe's Villages, a homeless healthcare service agency in San Diego, about how providers can help reduce burnout.

Look for ways to automate processes

Providers are often frustrated with the manual entry and duplicate work that can interrupt their day and take away from patient care. Finding ways to automate processes can help reduce computer time.

"See if your EHR can pull down records from hospital systems directly into your records system," Norris says. "A lot of electronic health records have the ability to do that. You just have to go through the process to explore and see what's possible. Talk to the hospitals. Build the interface."

Though doing so might be a challenging process, in the end, it's likely to increase efficiency and help decrease the time spent on data entry, he suggests.

Using connected devices can also help. Consider the lab tests you perform in-office. When you receive urine sample test results on a paper printout, someone is walking down the hall to deliver or receive the results. Then someone scans or keys the information into the EHR and it routes for approval again. This creates added steps for the providers as well as opportunities for errors.

One study found that physicians spend an average of 5.9 hours of an 11.4-hour day working with the EHR.5

Using software like Relaymed to connect your lab devices to your EHR can help reduce time spent handling results, where test results automatically flow into your EHR and become instantly available with 100% accuracy.6 By connecting more devices to your EHR, you can reduce computer time for physicians and other staff members.

Give physicians a team to help them

Physicians need a team to help with data management, Norris says. And this goes beyond a medical assistant.

"Make sure you approach things with team-based care so that you have folks to offload administrative tasks," he advises.

Consider inbox management. Emails, portal messages, refill requests and more inundate physicians 24/7. Let the physician's team give the inbox a first look and decide if the physician needs to see a message at all. One example, he says, is a patient who emails to reschedule an appointment.

"The physician doesn't need to be scheduling appointments, and for that reason shouldn't be the first person to see the message," Norris says. "You should have somebody able to triage and ensure that the appropriate person is addressing the patient's request."

Team members can also help with billing codes.

"The billing codes we use [are] another stressor for clinicians," he says. "Have other team members help assist with the process."

Use scribes to help take notes

Writing notes during appointments can take up a lot of time, Norris says. One solution is to have a scribe who takes notes while the doctor interacts with the patient. The doctor then reviews the notes at the end and edits them as needed.

Norris says his healthcare agency hasn't been able to hire scribes yet, so he's found another workaround in the meantime.

"Even if you don't have a scribe, there are strategies that can help decrease some of the pain," he says. "One thing I do — as long as it makes sense — [is] I read to the patient what I'm typing, so they feel included in the process...I say, 'Does that sound right? Am I hearing you correct[ly]?' I'm still staring at a screen and typing, but it's more participatory."

Consider flexible scheduling

Flexible scheduling can also help prevent burnout and even reduce inefficiencies. Your first step can consist of simply making sure that doctors have protected administrative time to catch up on things, Norris says.

"Don't expect them to fit in administrative tasks on top of everything else," he says. "That's going to lead to a sense of burnout. Creating that administrative time and ensuring it's protected gives the physician flexibility to get the administrative tasks done."

Also, be open to allowing staff and doctors to work on a more flexible schedule.

"If they want to work part time, really work with that," he says. "Don't expect everyone to work full time. That's going to box people out of the job market."

This is especially important with staff shortages from the pandemic.

"I think the pandemic has made all of this more challenging," Norris acknowledges. "People have issues with child care and just being overwhelmed. Being reasonably flexible with your staff can help decrease that. Yes, it means you have potentially fewer hours of physician or staff time, but it [also] means you're less likely to burn out your staff. You're more likely to retain them. So ask what's going to work for them and then see what you can accommodate."

Create a culture that welcomes honest, frank conversations

You'll want to identify the areas within your organization that are causing frustration and burnout for your team. List them by priority and then begin by tackling the top three, one at a time. Of course, before you can do that, you'll have to show you're capable of having open, honest conversations with your team.

"The first step is having frank conversations about what's not working," Norris says. "You cannot solve a problem you are not willing to name. We must be able to acknowledge our part in broken systems. If we get together [and] own our piece of it, then we can start to work on real solutions."

You may need to create a culture that welcomes frank conversations first.

"That really does start with leadership," Norris says. "It starts with folks at the top being willing to hear and listen and acknowledge those issues."

Sometimes you may not have the power to fix a particular issue, but you can still be empathetic and let your staff know that you appreciate how frustrating it is.

"Acknowledge those frustrations," he says. "Then where you do have control or workarounds, where you can make things more efficient, do your best to work on those things. Really listen to the people providing frontline care."

In short, the very first step in solving inefficiencies that lead to burnout is listening to the people in your organization.

"If you're not allowing people to have the space to voice what their concerns and frustrations are, then they're going to feel unheard, disempowered, frustrated and more likely to be burned out," he says. "That really is an essential."

In summary: if you're wanting to solve inefficiencies in your workforce, start at the top. Acknowledge your own frustrations, listen to the people around you and look for ways to make life easier for everyone. 

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