Doctor appointments are rarely fun, but the prospect of visiting with a rushed, curt physician only makes it worse.
So why are unsatisfactory interactions with doctors seemingly becoming more common?
It may be due to burnout, some specialists say.
Burnout, a term that’s gotten increased attention as technology erodes work-life boundaries and heightens expectations, can happen in any industry, but health care is especially susceptible.
“Not only do they have very frequently long hours and long shifts, their decisions are extremely consequential,” said Roger Achille, a business professor in
Johnson & Wales University’s master’s in human resources program.
But grueling schedules aren’t the only thing health care professionals battle.
Completing electronic medical records, which are required for each patient and document an extensive amount of information, can be a drain that affects physicians’ relationships with patients, said Dr. Deepan Dalal, a
Brown Medicine rheumatologist.
The daily task of completing electronic medical records for each patient is burdensome for many doctors because it is so time-consuming, said David Hemendinger, Brown Medicine’s chief information officer. He cited a recent Mayo Clinic study that found doctors nationwide spend an average of 28 hours per month outside of the workday entering information.
“The computerization of health care records has created a groundswell of dissatisfaction from the physician’s perspective,” Hemendinger said. “It can be a tipping point. Physicians have spent early parts of their careers practicing medicine, taking patients down the path to recovery, and when they’re hampered from their ability to practice true medicine, that can be extremely frustrating.”
At
Lifespan Corp., the state’s largest health care network, executives surveyed employees about 15 months ago to gauge their feelings on burnout.
“We found out we were in the middle of everybody else out there. We’re comparable to most of our peers nationally,” said Dr. John Murphy, executive vice president of physicians affairs.
While the use of electronic records was among top complaints, other concerns included being unable to eat meals during shifts and dealing with confrontational patients.
In response, the network set up seven working groups, each one assigned to a separate issue.
One change already in place is that the network sends out fewer electronic best-practice announcements.
“That resulted in 17,000 reduced messages to physicians in the first month,” Murphy said.
Lifespan leaders hope that additional training, combined with efforts to eliminate some of the clicks required to negotiate electronic records, will help streamline the daily process.
Administrators at Brown Medicine have made it a priority to acknowledge doctors’ frustrations.
“The first key thing is a recognition that physician burnout exists, and we need to find ways to mitigate burnout,” Hemendinger said.
A series of initiatives are being tested, including one that frees physicians from a computer while in the exam room with a patient. Visits are securely recorded and transcribed by a remote physician, who submits notes for the treating physician’s approval.
A second project is exploring the use of one authentication process to sign physicians into the systems they need to use to update records.
“It saves time; [right now] physicians have to have 10 to 12 username and password combinations to treat the patient,” Hemendinger said.
Another test eliminates the need for doctors to search through lengthy amounts of irrelevant data, including compliance and quality-related requirements, in order to produce lab results for patients. The system uses multiple pieces of software to gather information for doctors ahead of patient visits.
The human side of doctoring can be difficult to manage at times as well, Dalal said.
“People are seeing us because they are ill; they’re scared. They are clearly not at our office to have fun. They have a mission to accomplish, and sometimes you’re dealing with individuals who need to be calmed down,” he said.
Stress at work in any industry is a primary contributor to burnout, Achille said.
“[Stress] is often described as being contagious, and as a contagion it’s going to affect people differently,” he added.
Other factors include deadlines, workplace competition, conflicts with a supervisor or feeling overworked.
Employers can help by allowing flexible schedules and offering clear communication about work expectations, Achille said.
Communication is most effective when it’s mutual, he added.
“The employer has an ability to implement policies that may reduce stress in the workplace, but the unknown is what’s going on outside of work,” Achille said. “Stress can be created anywhere. Sometimes even employers who implement the most progressive policies still can’t take into account the stress the employee is experiencing outside of work.”
Elizabeth Graham is a PBN staff writer. Contact her at Graham@PBN.com
