Medicine Is a Firestorm of Change
Medicine is moving at Mach speed, and physicians are in the middle of its path. Regulation. Consolidation. New technologies. With so many forces bearing down on doctors, how do you stay sane?
We asked physician experts and consultants to talk about the leading causes of dissatisfaction and burnout among physicians, and to give practical advice on handling them.
Doctors Face Challenges From All Sides
There are plenty of overarching macroeconomic forces unsettling doctors: a sluggish economy, uncertainty about the impact of the Affordable Care Act, and the rise of narrow provider networks, just to name a few. But these big-picture stressors often take a backseat to the everyday headaches that fill a physician's long days.
Four out of 10 respondents to Medscape's 2013 Physician Lifestyle Report say they're burned out, and it isn't the distant, foreboding pressures that are primarily to blame. Instead, doctors cited a couple of everyday, pervasive reasons: "too many bureaucratic tasks" and "too many hours of work."
Not surprisingly, these common complaints share some underlying causes.
Office visits squeezed into packed schedules are a constant strain on physicians, says Christine Sinsky, MD, an internist in Dubuque, Iowa. Clinical care has become much more complicated. Patients are older, sicker, and often more overweight, and physicians are expected to monitor and document far more information than in the past.
"We have to do all this frantic multitasking, which leads to paying less attention, which leads to stress, which leads to burnout," she says.
Monitoring and documenting care has become more complex as a result of increased regulation, PQRS (the Centers for Medicare & Medicaid Services' Physician Quality Reporting System), meaningful use, medical home criteria, and other requirements.
"It's not just about doing the right thing for your patients," Dr. Sinsky says. "It's about proving to someone else that you've done the right thing, and sometimes the proving takes longer than the doing."
Clinical documentation is only the beginning. Physicians currently spend almost one quarter of their time (22%) attending to nonclinical paperwork, according to a 2012 survey conducted by the Physicians Foundation. With implementation of ICD-10 to take place in October, that percentage will likely increase.
"We spend too much time away from our patients dealing with checkbox-type medicine, and that really interferes with patient care," says Joseph Valenti, MD, a Denton, Texas-based ob/gyn and Physicians Foundation board member.
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Cite this: Staying Sane as Medicine Goes Crazy - Medscape - Jul 25, 2014.