Why Family Medicine Burnout Is Different (and How Docs Fight Back)

Interviewer: Laurie Scudder, DNP, NP; Interviewee: H. Clifton "Clif" Knight, MD, FAAFP


September 06, 2017

Editorial Collaboration

Medscape &

Strategies to Promote Autonomy

Medscape: Are there strategies that family physicians can use to promote autonomy in an institution that might not be as inclined to support it?

Dr Knight: Within organizations—hospitals, large group practices, whatever that may be—it is essential for family physicians to be able to advocate for maintaining their scope of practice and continuity of care. The business model of focusing on RVUs may be a good business model, but it's not a good healthcare model. We have to—all of us, individually and collectively as an association—promote systemic change that focuses on the care of patients and health outcomes. That may not necessarily end up being the most efficient business model.

If a physician's autonomy is being negatively affected by the organization in which they work, it's important to help that organization understand the win-win of allowing autonomy. Family physicians need to have the support of their peers, institutions, and professional associations to go to the organizations in which they practice and help these organizations understand how essential it is to allow physicians to have more say in how they're conducting their practice and providing their care. Physicians need to feel that they aren't just a commodity and that they are respected for their professional expertise. In order to provide the best care, to develop those relationships that are so critical to helping patients, this has to be more than just a job. Part of that is to allow physicians the leeway to implement changes that improve quality of care as well as patient and physician satisfaction.

Physicians willing to be advocates for doing the right thing for their patients, and improving care and focusing on outcomes, can help practice administrators, hospital administrators, and system administrators understand how that really benefits outcomes. Finance can't be the sole driver. But equally, physicians must recognize and acknowledge the concerns of administrators by saying, "So if there's a concern that there's going to be a negative financial impact, how do we work together to mitigate that?"


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