Burnout – Efforts to Save Physicians
The World Health Organization (WHO) has updated the definition for Burnout in the recently released ICD-11 Diagnosis Code Set – “Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” Background supporting the change in definition and reasons for upgrade in the classification system is well documented.
While everyone acknowledges the seriousness of the condition, few organizations, governments, or policies provide solutions. However, some initiatives have started. Recently the California Medical Association in collaboration with Stanford University, announced they are taking steps to address the systemic burn-out from the practicing physician.
The collaborative project includes efforts to 1) promote well-being for all physicians by encouraging collegiality and community-building support among the physicians, 2) provide individual coaching and tailored support at times of increased risk for burnout, such as when physicians have relocated or are going through malpractice suits, and 3) assistance for physicians experiencing burnout or who are considering leaving the profession.
Short-term solutions are also being addressed at the corporate C-suite level. For example, Cleveland Clinic, the Icahn School of Medicine at Mount Sinai and Stanford Medicine, have appointed Chief Wellness Officers in recent months in an attempt to ameliorate the burnout problem.
In addition, Team-Based Care Models have been suggested as a means to provide an environment to reduce working hours and make healthcare workers feel they are valued and respected. “Team-based care models tap physician assistants, nurse practitioners, medical assistants, and other relevant personnel to share responsibilities and allow all clinicians to work to the top of their skill sets” says Jack Stockert, the managing director of Strategy and Business Development at Health 2047.
Banner Health is working the solution directly at the source – the EMR. “Evaluating the effectiveness of EHR-embedded alerts”, that is – is the EMR-alert actually a benefit and helping the clinical team in their decision-making notes Dr. Marjorie Bessel of Banner Health. While the alert may have added value at some point previously in the EMR function, the alert at the present time may be an unnecessary disruption consuming valuable time from the physician. Updating the EMR through continuous system analysis provides best functionality to the EMR and gives time back to the physician as well as, shows respect for the physician’s well-being and practice of medicine.
Long-term solutions are required to improve the well-being of healthcare workers and provide for a safer, secure environment. At the federal level, the government must address the continuous and frequent updates and changes to requirements. Quality metrics, and diagnosis and procedure codes are required to provide for safe patient care but, changes to meet payment requirements must be re-evaluated. Is a new national quality plan needed every 3-4 years which requires providers invest hours of manpower and financial resources to update systems and educate staff? Can we accept our healthcare system and payment model (FFS / VBC) without these frequent changes? While the road a fully functioning healthy environment still seems long, the landscape is clearing.
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