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Ep. 35 The Truth Behind Clinician Burnout

by | Dec 13, 2022

In many industries, the prevailing advice for burnout is to take time off or take more breaks. For many clinicians, suggestions like these indicate a lack of understanding of why healthcare professionals end up with burnout. Within days of coming back from a vacation, a provider will go right back into thoughts of quitting. Within minutes of driving home from the office, the provider will realize they could have left on time if they didn’t take a lunch break. 
In this podcast, we put in the spotlight the broad-ranging impact burnout has on all levels of care beyond clinicians themselves. The clinician’s family, patients, support staff, managers, and sometimes even the executives can feel the detrimental effects of a provider’s burnout. We also explain why more technology isn’t likely to help, but why a “practice redesign” is. 
Host Celina DeFigueiredo-Dusseau and Vice President of Growth Chad Anguilm have a frank discussion about the state of burnout, its primary causes, and how some proposed solutions are more feasible than others. They also talk about what clinicians are thinking and feeling while on the road to burnout.   

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Key Takeaways from Podcast Episode 35 The Truth Behind Clinician Burnout 

What Burnout Looks Like From the Perspective of an Experienced Healthcare Consultant 

Well, provider burnout is a new conversation for many in the past few years but thankfully we are getting away from the pat answers of trying yoga and other retreats that were often suggested to burned out clinical professionals that didn’t even have time to do their own job, let alone have daily sessions at the yoga studio.  

As we work in practices, elbow to elbow with these clinicians and their staff, we are witnessing burnout every single day. We see sadness, lack of interest, distancing from patients and staff and fatigue in everyone’s eyes. We are seeing burnout every single day and we are out there trying to make it better. Thankfully, there’s a lot of options, there’s a lot of opportunities and we’re seeing light at the end of the tunnel. 

The Real Common Causes of Burnout 

If you ask ten clinicians, you’d probably get eight of them that bring up admin tasks right from the start. Things like filling out forms, figuring out prior authorizations, network restrictions, the pressure from insurance companies to make profits, documentation of quality metrics is a huge undertaking – so is dealing with different formularies.  

All this comes at clinicians when they just want to care for the patient and take advantage of that face-to-face time. That is valuable time as a clinician you’ll never get back. If you are spinning around in circles and pounding on your keyboard the whole time, you’re not getting to build that relationship with your patient. So, it’s time to acknowledge that admin tasks are a big problem.  

It’s a safe bet that clinicians would say the afterhours workload is a top contributor to burnout. After you’ve pounded on the keyboard and are still not able to find what you need, creating an awkward moment in front of your patient, you put that to the side and say, I’ll do that when I have time. When do you have time? After hours when you’re supposed to be resting or with your family or just seeking that work-life balance. And unfortunately, many clinicians now are spending all their time focusing on their job instead of seeking that work-life balance.  

As industry experts, we are well aware that IT related tools and software hurt efficiency and contribute to burnout. And what does that mean? This pairs with, again, the need for insurance companies to seek profits, plus all these new rules related to quality metrics and documentation. So much is being thrown out there at the same time, and technology just adds to the chaos.  

Clinicians are frustrated with tools that increase complication rather than lessen them. “Why is the EHR making me do this? I don’t understand why it’s having me do tasks that somebody else used to do. It’s making me document quality metrics that I know I’m taking care of. My patients are very healthy, I do a great job but now we’re in a spot where so much information must get back to the insurance companies to prove it’s been done.” A lot of these clinicians don’t have the time to sit there and spend 45 minutes to an hour completing a note that proves they did their job. Naturally, this is super frustrating.  

You can see where all three of these things are interwoven. They’re struggling to use technology and technology most commonly gets the negative connotation. Why? Because it’s not set up properly. As EHR consultants, we work on solutions every day with different groups, and we start to see, again, light at the end of the tunnel when everything starts to connect and function. But bottom line, things are changing so rapidly as well. Even if you are investing in technology and trying to keep it as efficient as possible, things are changing and it’s hard to hit a moving target.  

Practical Ways to Mitigate Burnout 

Come to find out, it is not the retreats nor buying a new technology that’s shiny and promises the world that is successful in this quest. What works is adding medical assistants, adding scribes – either in-person or remote – to create and spread out the work within the practice.  

Of course, when you talk about expanding the workforce within an organization, cost is the first thing they ask about. There are creative ways to find revenue for this such as the new quality programs out there, new codes that increase reimbursement. Our consultants have found ways to help practices pay for some of these new services so they can even out the work and make the practice more effective.  

In the end, it pays off. Getting those scribes involved to fully document what the clinicians are thinking rather than constantly turning to a computer means they can smoothly get onto the next patient. Improving patient flow in such a way makes the practice more welcoming for staff, clinicians, and patients. 

Having a social worker in the practice is also valuable assistance for a clinician. Sometimes issues come up during a visit that fall outside the scope of what a clinician can do. Rather than spend extra time fumbling to address the problems or coming off as apathetic, clinicians can hand off this responsibility to those who have the training and resources to help patients improve their quality of life. Care managers and social workers getting involved helps the practice all the way around. Not only does this take some of the burden off the clinician, but it also helps improve quality metrics as patients get the outside help they need to successfully reach their health goals. 

The stock answer to burnout is reduced hours and more vacation time, and this becomes more feasible when the practice is set up properly for success. How can a clinician take time off when most of the burden is on their shoulders? The fix is focusing on empowering staff to take back some of those tasks that ended up in the clinician’s lap but can be handled by other medical professionals. 

On that note, it’s a growing possibility that we, in the industry, are going to see a big boom in nurse practitioners and physician assistants opening practices and taking on more of the healthcare system. Payers are starting to see that is the future and this is a promising sign. We’ve seen some good relationships with not only NPs and PAs and their patients, but also NPs and PAs with physicians and specialists. It’s encouraging to see the healthcare ecosystem work, and more and more states are opening full authority for that.  

Ultimately, it’s about changing the way that you’ve always done things and, little by little, shifting to a modern approach. But also integral to the success of this restructuring is a team approach where so much is not placed on the shoulders of the lead clinician.  

Why There is Low Participation in Burnout Reduction Programs That Have Been Shown to Be Successful 

The biggest thing is these clinicians don’t have the time to care for their patients like they would like to let alone go and attend an offsite retreat for a long weekend. It’s just not realistic but could be possible down the road if you focus on optimizing practices – getting patient flow and patient engagement where it needs to be. What will also free up a clinician’s time is rebalancing the workload that shifted due to the EHR. So many tasks that the staff used to do are now the clinician’s responsibility because of how the EHR operates. The idea is to balance out the workload so that everyone can have the benefit of a work-life balance, but still care for your patient population.  

Aside from personnel issues, you can also look into reimbursement issues. It’s frustrating to do the work, but not get paid for it. Some solutions include cash pay, adding new payers, or even dropping payers that aren’t easy to work with.  

So, we’ve seen major adjustments, but there again, it’s all around optimizing what you have in front of you. To be an effective modern practice, changes must be made such as upgrading to new tools and technology that are now available. 

Some solutions have been found outside the practice. For example, a practice can gain additional support by joining an ACO (Accountable Care Organization). Some entrepreneurial groups also go into concierge medicine where clinicians can have more freedom through ownership.  

A Realistic Forecast for Clinician Burnout Going Forward 

As we desperately need relief for burnout in healthcare, it would be wonderful if we could say that we’re going to stop talking about burnout within a year but that’s not realistic. We, as a healthcare community, are still at least a few years away from getting where we need to be. We’ve got a flawed healthcare system right now and because of that we feel like we’re digging out of a hole, and there are a great number of people fighting for the clinicians, and as healthcare consultants, we are one of those groups. 

Interoperability is major. It’s supposed to make patient information readily available to providers, but unfortunately, that’s not happening for many clinicians. It’s hard to have a conversation with a patient or provide effective care without such information. By the end of the day, that happens over and over, and as a clinician, you’re probably saying to yourself, “I can’t do my job without the access to the information,” and that ultimately leads to fatigue. 

More and more interoperability-related rules continue to arrive, like the Cures Act and others that aim to stop information blocking, but it’s a slow process. Healthcare providers are at the mercy of powerful companies across the board – from software companies to insurance companies – increasing the burden on providers. 

Instead of waiting for interoperability to sort itself out, there are things to be done at the clinic level. Revamping, redesigning the office can be the fastest moving fix to burnout. Unfortunately, we’re still seeing a lag when it comes to the payers funding those services that are so necessary. Programs will pop up here and there, but none seems to stick. There are ways to make it work if you’re willing to do the reorganization necessary. We’ve worked with some groups that are super successful now due to incorporating care managers and social workers within their practices. They work with remote scribe companies to bring new employees in the office.  

Technology like virtual front door can empower patients to do more and save your practice time. Tell patients, “You will be shocked at how much you can accomplish without having to call the practice.”  

Instead of having patients on the phone all day taking up hours of your staff members’ time, direct them to use the patient portal. Reversing that dependence on phone communication comes in the form of talk track buy-in from the entire practice where staff are trained on effective ways to increase patient engagement with the patient portal. We’re seeing that if you can get everyone to buy in within the practice, the patients will surely buy in very quickly. 

A Practical Approach to Confronting the Clinician Burnout Epidemic at the Clinic Level 

There’s no magic solution. You’re not just going to buy a piece of technology and suddenly, you’re fixed. Instead, turn the focus to redesigning the practice and stakeholder buy-in. The change will be widespread but will require the cooperation of the entire care team.  

That starts with assessing what you currently have – everything from your workflow and processes to technology – and going from there. A clinician once revealed, “I feel like I’m on my thirtieth EHR and I’m in the exact same spot I was after purchasing my first.” This sentiment encapsulates why focusing on EHR optimization to align and connect everything properly is the most effective solution. Out-of-the-box base solutions just aren’t effective as-is. 

Have a full assessment of your practice so experts can recommend the best solutions – solutions they’ve seen work for dozens of practices. As mentioned before, this is about redesigning and reorganizing the practice, and healthcare consultants can help you execute these steps more effectively. 

Discover Clinician Burnout Solutions with Experienced Healthcare Consultants  

Practices everywhere feel the impact of clinician burnout. Bittersweet farewell to beloved clinicians, increased workload on the clinicians who remain, and care quality decline are just a few of the many ways practices will take a hit from burnout. Because clinician burnout is such a complex challenge, it can feel like there is no way to stop it, but there are steps that can be taken to reverse some of its effects, and such changes can be a catalyst for even more positive impact.  

With a full practice assessment from seasoned medical practice consultants at Medical Advantage, you can begin to counter issues causing the dread some clinicians are experiencing. Our consultants have worked with hundreds of practices entrenched in burnout challenges, and with the experience we have gained, we can offer the solutions that have an excellent chance of success.  

Ready to walk away from the status quo where clinician burnout thrives? Reach out to us today and begin seeking solutions. 

Speak with one of our Healthcare Experts today.

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