Posted on 10/03/2022 4:34:55 PM PDT by nickcarraway
Delegating refills, referrals, and other office tasks will get us back to what we love to do
Well, since it's been published in the New York Times, it must be true. Turns out, healthcare providers are burned out.
In a big article last week, the New York Times reported on dramatic increases in burnout reported among physicians and other healthcare providers, based on a recent article on a large survey of healthcare providers published in Mayo Clinic Proceedings. As if we didn't know.
I'm sure there are many out there who are not burned out, who are doing just fine, going about their days and getting everything done with style and grace. But almost everyone that I talk to, and also from what I hear from so many others locally, regionally, and nationally, the level of stress and burnout among physicians is unprecedented, and probably massively underreported.
All the online questionnaires we get about wellness and burnout, asking us to rate how satisfied we are with our jobs and how likely we are to leave our job and move to another institution, another healthcare setting, or another profession seem like blunt instruments unlikely to get to the true source of the problem and its depth. It seems like everybody everywhere is stressed, if not to the point of near-breaking, then maybe, just maybe, headed dangerously that way. We see this manifesting in so many ways -- frustration boiling to the surface, outbursts of anger, withdrawal from interactions with others, seemingly lower levels of compassion and empathy. Of course, this has all been heightened by the pandemic, and the state of the world today, and the political and social environments we are all functioning in.
So what do we think the answers should be? How can we make this healthcare system better; how can we make it a great place for patients to get healthcare and for doctors, nurses, and everyone else on the healthcare team to deliver that healthcare?
When we hear about institutional responses, they are often trying to make little inroads into the things that pile up on top of our shoulders. Does anybody really think that a certificate for a yoga class is going to do the trick? Reminding us that we should get plenty of sleep, get more exercise, and build nurturing and supporting relationships among our colleagues, family, and friends, sounds like a good idea. But then we return to work the next morning and are faced with a barrage of in-basket messages, phone calls, faxes, forms that need to be completed, and so much more that we never trained for, that we shouldn't have to handle, and that has very little to do with actually taking care of patients and delivering healthcare.
The time has come for us to recognize that to make the system one in which we all love working, we need to build one that our patients love coming to and can seamlessly navigate through to get to their best health.
When our patients are frustrated, we are frustrated. When they can't reach us on the phone, we have to spend the first few minutes of our office visit apologizing and trying to do service recovery. When the wait to check in at the front desk is 20 minutes for a 20-minute appointment, we're unlikely to get off to a good start. When we tell them that the wait to see the specialist they need is 3-6 months because of their insurance, we've failed them. When we cannot give them telehealth options because of the Zip code they live in, we've missed out on priceless opportunities to help them. When no one calls them to tell them what their test results are, when patients are unclear about what they need to do next, when we lack the systems to communicate between providers to successfully manage patients through a health issue, we are all destined to fail.
So perhaps the answer isn't discounts on a gym membership or a free smoothie at the hospital cafeteria or even tickets to a Yankees game. Maybe it's admitting that our healthcare system is broken, and if we fix it from the standpoint of the patient, we can almost guarantee that it will be a better place for us all to practice, work, and live in.
We need to demand all of the resources we need to get this job done in the healthcare environment as it exists today, and then move towards a system that no longer requires a lot of these extra things. Referrals, refills, and simple message responses need to be off-loaded from providers. An adequate staff to manage the phones and a fully fleshed out team of people helping us with the day-to-day tasks can go a long way to eliminating the chaos and confusion that prevails and leads to so much burnout. Maybe one day we'll even get smart enough to eliminate referrals altogether, to make refills seamless, and to build in patient education about all of a patient's healthcare issues, so that everybody gets all the information they need to take care of themselves in the best way possible.
It's not going to be easy, it's not going to be cheap, but as it stands we're spending so much more money on a healthcare system that just isn't working, that there's got to be a better way.
I'm sure the accounting folks out there are going to tell me there's no business model that they can foresee this works in, and there's no way they can afford this. What I'm telling you is, there's no way they can't afford it.
Maybe stop forcing them to take repeated shots of a dangerous vaccine by threatening their jobs?
Maybe by giving the “patients” some early therapy treatments?
Cry me a river. Try being in construction in Florida. Literally 7 days a week since October 2018.
You’ve worked seven days a week for five years?
Doctors used to be less obsessed with money, they made great money but had fewer patients and dealt with each one as an individual, now they have factories and the practice is a cash machine for their real interests, like real estate.
I remember when they would make a house call if someone needed it and they would talk to you and listen to you.
Maybe they could work Friday. I would bet most people over 45 are burnt out if they are working.
I have a lot to say about this being a currently practicing MD, just passing my 31 year mark. For now, just a bookmark.
The short version is, that medical malpractice still runs the roost and all the stuff we find annoying and time consuming and barriers to care are all built to keep the bad outcome lawsuits away. If this country is serious about access reform and providing timely care to far more people, then reforming medical malpractice is the very first step. Not EMRs, not system changes or bigger teams, its malpractice reform. Without that. we will continue to have to build giant monoliths with every blood pressure check. I am not holding my breath.
What’s clear however, is that any answer that says let government run it because it will be more efficient, cheaper, better etc, please find a pier and just keep walking.
You are correct. In every word.
Maybe those “patients” should seek advice elsewhere. I hear the farm store has what you need. Go get it and stop trying to dictate the practice of medicine. You don’t have to agree with it. So seek care elsewhere
“Referrals, refills, and simple message responses need to be off-loaded from providers.”
Sutter Health in the San Francisco Bay Area did that LONG ago. All my routine requests are handled by a staff person who is not even a Physician’s Assistant or nurse.
The downside of government requirements and codes is that my annual physical was reduced to my doctor pounding the keyboard for 45 minutes. He’d take what I said and enter it into the EPIC system. EPIC is good, but it and the government requirements sure killed the doctor / patient relationship. My doc just left to be an executive at a health tech startup company. He probably figured if he was going to have to do administrivia all day long, he might as well do it in a young company with financial upside. The irony is he was the guy who implemented EPIC over a decade ago.
There has been a yuge corporatization and governmentation of HC over the last 30 years.
It’s more than a bit tough to find a single practitioner now.
It’s a plan to be on good terms with your veterinarian....
The same thing has happened in Australia (healthcare here is a mix of government and private). The increase in healthcare costs around the world (regardless if it’s the public or private sector) amaze me and I’m used to defence sector levels of cost increases.
How can we make this healthcare system better???
1. Eliminate 3rd party billing except for Catastrophic Care plane, All health insurance plans should e High Deductible with NO coverage until it has been met, $10,000 works for me.
2 Posted Accurate prices before treatment, just like everyone else.
3 The Hospitals and Health Insurance companies have LOST at the Supreme Court 3 times already regarding Anti Trust Laws that they willfully Violate every frikking day.
The vast majority of Hospital Administrators and Health insurance execs, and Doctors, Belong In PRISON and to be Asset Stripped to the clothes on their back for their willfull FELONIES that carry severe prison sentences and extreme civil fines.
Robinson Patman
Sherman Clayton
ANTI TRUST, READ THEM!
PROSECUTE THEM NOW!!!
4 years, yes. Outside 2 weeks in the hospital, major holidays and a few funerals, yes. We are still rebuilding from hurricane Michael in October 18. We all do what we must. PC to Port Joe. I didn’t take holidays off until Easter 2019.
My doctor got tired of not being able to practice medicine. He had 3000+ patients on his books. He moved to a concierge type of practice. Now Iwe don’t have to fight 2700+ other patients to get appointments for quality care. Those 2700+ are pissed. Lol. I don’t care. I have his personal cell #.
I think concierge medicine is a wonderful way to go. It provides a free market solution to everyone. I have zero problem with the entire concept.
Oh please. How are doctors in collusion to violate antitrust laws. This is the most idiotic argument I have heard in a while. When we’ll do 50% of healthcare is paid for by the government the only entities in collusion is the federal government itself.
Why don’t you read what the fundamental definition of a monopoly is. Additionally there are all sorts of providers out there — chiropractors. Mid levels. Homeopaths. Even since covid apparently farm stores. Who is limiting your choice to seek alternative therapy.
You Should be stripped of your assets down to your shirt and thrown into prison for ignorance in the first degree.
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