With thoughtful improvements to how technology is employed and measured, physicians can return to the joy of practice.
Of the many reasons contributing to increasing rates of physician burnout, technology often rates as one of the greatest frustrations. A recent Mayo Clinic study on physician satisfaction with their electronic health records (EHRs) showed that only 36% of 6,375 physicians interviewed were satisfied with their use. Furthermore, a majority of respondents indicated their systems were causing a clinical burden, resulting in emotional exhaustion, depersonalization and a reduced sense of personal accomplishment.
“We’ve burnt out a generation of clinicians despite the greatest advances in technology in healthcare,” says Bridget Duffy, MD, chief medical officer for the healthcare communications firm, Vocera, and co-founder of the Experience Innovation Network, a research collaborative that focuses on alleviating physician burnout.
Coupled with administrative and payer bureaucracy, she adds, “these competing forces are keeping physicians from being at the patients’ bedside practicing medicine.”
Duffy does not, however, recommend ditching technology as the answer, but instead thoughtfully employing these tools in ways that can remove hassles from physicians’ work days. “Physicians can no longer be data entry clerks,” she says. Instead, healthcare systems and practices must find technologies “that enable and restore the sacred relationship between physician and patient.”
These solutions could range from voice-activated software that could interface with EHRs-like an Amazon “Alexa” of medicine, allowing a physician to sit and dictate while still looking a patient in the eye, to employing medical scribes. To address physician frustrations with their EHRs, she says it is useful to remember that these systems are a “repository for financial, clinical and regulatory information… not a tool to enhance and enable the physician to patient encounter.”
Physicians can also employ non-technological tools to reconnect themselves in the face of burnout, such as “the creation of rituals before walking into a patient’s room,” she explains.
She cites several examples: a pediatrician who sets down his phone and pager before entering a patient’s room and who told her there should be a metric for how present and engaged a physician is with patients; an OBGYN who centers herself with deep breathing before performing C-sections; and a heart surgeon who gets out at a local pond on his way home and stands there for one minute to leave all of the stress of the day there before going home to his wife and children.
“The concept of a ritual to reduce stress is really important,” she says.
However, she acknowledges that you can’t just throw mindfulness meditation or rituals at physicians who are burned out and expect that to be enough. In order for hospitals and healthcare systems to do this well, she recommends that they first need to understand the “top three pain points in a physician’s day” and then design for an ideal day in the life of that physician. “You need to remove the hassles and amplify the joy,” she says.
If “joy” sounds like a foreign concept in the life of a physician, all the greater the reason to look for ways to create more of it, she suggests. But to do so requires designing new metrics to measure the health of physicians and the health systems before and after technology is employed.
Duffy is part of the National Taskforce for Humanity in Healthcare, which is working on metrics for both well-being and resiliency for physicians and healthcare systems. Their goal is that healthcare systems could perform a baseline measure of resilience and well-being before any new technology is rolled out, and then measure it afterward as well. Then, she feels, they would be able to assess more accurately if the new technology is easing physicians’ burdens or adding to it.
In offloading the bureaucratic hassles, she feels there will be less burnout.
The joy comes from the human-to-human interaction and connection with the patient. “If I can’t look in their eyes, I can’t witness their suffering and I can’t help ease their burden,” she says.