Physician burnout affects patient safety, quality of care, and medical costs, and is a threat to the U.S. health care system. Medical transcription outsourcing helps alleviate the problem to some extent. However, according to a recent report in EHR Intelligence, top healthcare CEOs point to EHR technology as a key contributing factor to physician burnout. Industry stakeholders consider physician burnout a public crisis.
Negative Effects of Physician Burnout
The healthcare CEOs who authored a report published in Health Affairs draw attention to two studies that reveal the negative effects that physician burnout have on the quality and cost of care.
- Mayo Clinic’s prospective longitudinal studies show that for every 1-point increase in burnout score, there is a 43 percent increase in likelihood a physician will reduce clinical effort in the following 24 months
- According to experience from Atrius Health, replacing a physician who retires early or leaves to pursue other career opportunities can cost between $500,000 and $1 million due to recruitment, training, and lost revenue during this time.”
The CEOs point out that high levels of physician burnout could be seen as an indicator of poor performance by the underlying system and environment.
Reasons for Physician Burnout
Healthcare worker burnout is attributed to various factors that have altered workflows and patient interactions. These factors include:
- Loss of control over work: A study published by the National Center for Biotechnology Information (NCBI) found that time pressure during office visits affected 53.1% of physicians, while 48.1% said their work pace was chaotic, 78.4% reported low control over their work, and 26.5% noted burnout.
- Increased performance measurement: Today, performance measurement is one of the key factors in the efforts to improve health care quality, cost, and patient experience. However, quality reporting can take a toll on physician practices in time and money, according to a 2016 report in Modern Healthcare. Several hours are spent each week on quality reporting. Increasing responsibilities and stress lead to physician burnout.
- Increasing complexity of medical care: The increasing complexity of modern medicine has exceeded the ability of an individual doctor to deliver care safely. With thousands of diagnoses and thousands of drugs, physicians find themselves under greater stress. Clinicians must understand each patient’s specific issues and tailor therapies accordingly. They must monitor the patient’s treatment progress, whether drugs are causing any adverse effects, and take steps to prevent interactions between the patient’s drugs and treatments for other health conditions. Managing this rapidly increasing complexity of care can be very stressful.
- Inefficiencies in the practice environment: Practice environments are extremely chaotic and inefficient due to both incompetent administrative and care processes. Conflicting payer requirements and complex documentation, billing and coding are among the reasons for a stressful work environment. If they do not have efficient support, physicians find it difficult to deliver quality care. They have to be exceptionally vigilant to avoid errors. All of this perpetuates physician burnout.
Role of EHRs in Physician Burnout
Implementation of electronic health records (EHRs) is a major reason for physician stress. Last year, a nationwide study led by Mayo Clinic and conducted in collaboration with investigators from the American Medical Association linked EHRs to physician burnout and dissatisfaction. The amount of time needed for clerical tasks (data entry in EHRs) was linked to low levels of provider satisfaction with EHRs and computerized physician order entry (CPOE).
While EHRs can improve patient safety and enhance coordination of care, they have drastically changed and disrupted established workflows. EHRs have become a source of interruptions and distraction, taking the physician’s attention away from patient care. EHR data entry is also very time-consuming. The healthcare CEOs published their report in Health Affairs say that delivery organizations, organized medicine, payers and other stakeholders need to work with EHR vendors to improve their product offerings, which could reduce that EHR burden on physicians.
Medical transcription services can play a key role in addressing physicians’ issues with EHR documentation. As a recent article from the Center for Health Journalism says, “Giving doctors more time to dictate their charts is good. Allowing more time per patient is better. And providing a scribe, a trained medical transcriber to document everything in the visit while the doctor focuses both eyes on the patient and thinks instead of hunts and pecks, is best.”