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From 2011 to 2014, physician burnout increased by nearly 20 percent as providers continued to struggle with insurance disputes, demanding patients, and electronic health records (EHRs) reporting nightmares, a new study reveals.
Research from the University of California (UC), Riverside School of Medicine, shows that 54.4 percent of physicians in 2014 said they were burnt out, up from 45.5 percent three years prior. That’s an increase of 20 percent.
The UC team examined how “installation of an ambulatory EHR at OB/GYN practices and its subsequent interface with an inpatient perinatal EHR affected providers’ satisfaction with the transmission of clinical information and patients’ ratings of their care experience.”
Data from providers was collected through periodic satisfaction surveys conducted during implementation of the EHR, while patient satisfaction data came from standard surveys used by the healthcare network.
As Healthcare Finance News writes, the researchers cited three main factors contributing to increasing physician burnout:
For one, the doctor-patient relationship has been morphed into an insurance company-client relationship, imposing limitations on the treatment doctors can provide to the insurance company's members.
Then there are feelings of cynicism, resulting from patients no longer expecting continuity of care and routinely changing doctors. The third factor the authors identified is a general lack of enthusiasm for work.
Emergency medicine, family medicine, internal medicine, and pediatrics were the medical specialties reporting the highest levels of burnout.
There were several transformational changes to medical practices between 2011 and 2014 that may have fueled the rise in physician burnout – including the Affordable Care Act, rising drug prices, pay-for-performance, and the acquisition of medical groups by hospitals – but the UC researchers said mandated EHRs likely were the top cause.
While EHRs initially were embraced “due to the promise of government subsidies, chartless offices, interconnectivity and higher physician pay,” Healthcare Finance News writes, providers found that costs rose once subsidies ended. Providers also reported spending less time with patients and more time in front of a computer screen.
While there are no easy solutions, the UC team urged providers to retain a patient-centric approach during implementation of an EHR.
“Dissatisfaction of providers with an EHR system and difficulties incorporating EHR technology into patient care may negatively impact patient satisfaction,” the researchers said. “Care must be taken during EHR implementations to maintain good communication with patients while satisfying documentation requirements.”
The UC study is the latest in a long line of research on the impact of EHRs on physician burnout. A 2017 study by the Mayo Clinic and American Medical Association concluded that nearly "one in five U.S. physicians intend to reduce clinical work hours in the next year, and roughly one in 50 intend to leave medicine altogetyher in the next two years to pursue a different career."