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.
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.
Contact Our Team Today
Full Episode Transcript
Medical Advantage Podcast: Welcome to the Medical Advantage Podcast, where you can hear healthcare professionals, expert consultants, and industry thought leaders discuss the exciting new ideas and technologies that are changing the business of healthcare. Tune in to each episode as we hear from some of the most innovative minds in medicine about the future of healthcare and how your organization can stay profitable, efficient, and on top of industry best practices.
Celina DeFigueiredo-Dusseau: Welcome everyone to the Medical Advantage Podcast. I am your host, Celina Dusseau, and today we are joined by Chad Anguilm, Vice President of Growth here at Medical Advantage. For those of you new to our podcast and new to us Medical Advantage is a healthcare services company providing a broad portfolio of services for medical practices, specialists, groups and private equity. Today, we will discuss the critical importance of reducing and eliminating clinician burnout. Today we’ll seek to understand what is clinician burnout, identify signs of burnout in clinical staff, recognizing causes and offer solutions to ensure that all of our providers are supported and balanced in their roles.
We will discuss the impact burnout has, not only on the clinician, but the broad ranging impact that it has on all staff, patients, and healthcare organizations at large. The past few years have proven particularly challenging, rapidly accelerating an already elevated prevalence of clinician burnout. So today we want to understand the current state of burnout, the primary causes of burnout and disengagement, but most importantly, how do we look ahead to mitigate this challenge and seek a more positive environment for all providers in our industry?
Acknowledging and understanding these challenges helps us to seek innovative and impactful solutions that meet and hopefully exceed the needs of providers, patients, and medical staff alike. Chad, thank you as always for joining us to share your insights and experience.
Chad Anguilm: Absolutely. Thanks for having me, Celina. I’m glad to be here.
Celina DeFigueiredo-Dusseau: I’m really looking forward to hearing your current thoughts on the state of clinician burnout. This is certainly not a new topic, but in the recovery from the pandemic and the healthcare staffing crisis, there’s a concerning increase in reported burnout, resignation and early retirement in clinicians as seen in modern reporting for 2022.
I guess to get us started, I’d like to understand from your perspective what frames and defines burnout in today’s modern healthcare landscape.
Chad Anguilm: Absolutely. And Celina, as we talked about bringing this topic to the pod, I had mentioned that I’ve been on three or four different clinician burnout committees over the last eight or nine years.
So I’ve been doing in-practice work for just over fifteen now. In eight or nine of those, we’ve been talking about clinician burnout. And unfortunately, we’ve got a flawed healthcare system right now. We’ve got, unbelievable uncontrolled costs. And unfortunately, it’s not getting better.
There’s a snowball effect. COVID brought many new challenges and expectations. So unfortunately we’re seeing it every single day. We’re in-practice, elbow to elbow with these clinicians and their staff, and you just see the sadness, the really lack of interest and even distancing themselves from the patients and other staff. You can just see the fatigue in everyone’s eyes. We’re seeing it every single day and we’re definitely out there trying to make it better.
But there’s a lot of options. There’s a lot of opportunity. We’re seeing light at the end of the tunnel. I think we’re getting away from yoga and different retreats that 5, 6, 7 years ago, everyone was throwing out there to a group of professionals that didn’t have time to do their own job, let alone, leave for retreats and spend daily time at the yoga studio. So I’m excited to talk more about this today.
Celina DeFigueiredo-Dusseau: Thank you Chad. And as you mentioned these items, these definitions are certainly not new. But unfortunately in the past couple years, those terms are becoming more and more prevalent in day-to-day conversations, day-to-day operations, and now all healthcare staff are really on high alert to identify some of these behaviors and reduce them in all of the defining parameters that we understand around burnout. But naturally there’s some notable causes and precursors to some of those behaviors and identifiers, and those have certainly evolved over the past couple years but we do see some common themes.
Can you talk us through what some of the most common causes of burnout are now today?
Chad Anguilm: Yeah. I think if you ask ten clinicians, you’d probably get eight of them that bring up admin tasks right from the start. So things like filling out forms, figuring out prior authorizations and that whole process, network restrictions, the need for insurance companies to make profits. Documentation of quality metrics is huge. Dealing with different formularies. All this stuff coming at them when they just want to care for the patient. They want to take advantage of that face-to-face time. That’s time as a clinician, you’ll never get back. And if you are spinning around in circles and pounding on your keyboard the whole time you’re not getting what you need from that relationship with your patient. So admin tasks are a big problem. And like I said, I bet eight out of ten, if you survey, would say that after hours workload.
So all that stuff when you’re pounding on the keyboard and you’re not able to find when you’re face-to-face with 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 of their time focusing on their job instead of seeking that work-life balance.
Let’s say tools, IT related tools, software that hurt efficiency. And what does that mean? I think it pairs with, again, the need for insurance companies to seek profits and all these new rules related to quality metrics and documentation. It’s all being thrown out there at the same time and the blame is often the technology.
The EHR is making me do this. It’s making 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 that’s got to get back to the insurance companies to prove it’s been done. And oh, there’s a real efficient way to do that using technology A, if it’s all set up correctly. And B if you, and again, going back to time, a lot of these clinicians don’t have the time to sit there and spend, 45 minutes to an hour on a note to get everything in there to prove that they did their job and that’s super frustrating.
So I think all three of these things are interwoven. They’re struggling to use technology. A lot of them bought the baseline package from the technology company because of cost. When you’re looking at buying a new EHR or maybe you are buying a dashboard product or patient portal website combination, virtual front door.
That’s a lot of money and you’re trusting the rep that you’re talking to at the software company to guide you in the right direction to make you successful. But often it’s a money play and you say, I’m going to buy this baseline package. Unfortunately, you’re often getting the baseline implementation, the baseline product, and nothing connects.
It’s here you go out of the box and it doesn’t make you more effective or efficient in your practice. There’s oftentimes a need to connect all those different solutions and optimize them for your need for what payers you’re working with, for what quality programs you’ve joined for, the patient population that you have, for how you’re seeing patients.
Are you doing it all in person? Are you adding some virtual? There’s a lot of different things that go into making you more efficient using technology. So I think technology. It gets the negative connotation, most commonly, because it’s not set up properly. We work to do that every day with different groups, and we start to see, again, light at the end of the tunnel when everything starts to connect. But bottom line, things are changing so rapidly as well, that even if you are investing in technology and trying to keep it as efficient as possible, things are changing and it’s hard to catch a moving target.
Celina DeFigueiredo-Dusseau: You’re spot on there, Chad, and it addresses the age old question. Does that technology cure the problems or does it cause new ones?
EHRs are designed to reduce time spent on those tasks that lead to more hours tacked onto the end of the day, but largely that’s dependent on the implementation, the training of that technology to be able to augment the practice. So just like you said, it, it’s tough to achieve a moving target as technology’s always growing and changing, but the better process that can be put in place for leveraging that technology in a way that makes the most sense for your specific practice, the more successful it will be.
And you can see where the technology then takes some of the load off of not only the clinicians, but everyone in the clinic. So with that knowledge, we can definitely see some themes between some of the defining behaviors of burnout and the causes of burnout that you’ve discussed here, such as the administrative tasks, extensive hours, unsupportive technology, and how that results in those really visible and measurable effects of burnout.
Such as disengagement, potentially reduced quality of care, and just an overall negative feedback loop. Burnout impacts all levels of care from senior executives to patients and families and everywhere in between. Chad, knowing the causes and effects of burnout in clinicians now I think our next biggest question. Where do we go from here?
There are countless initiatives that have been tested over previous years to reduce and prevent burnout. Definitely some more impactful than others. So can you talk us through some mitigation strategies? Ultimately true solutions target, the root cause, and I’d love to hear your thoughts on what best practices are today for developing mitigation strategies that will have meaningful impact in the field.
Chad Anguilm: A lot of the clinicians went into medicine to connect with and treat their patients right. Unfortunately that’s being eroded by other non-patient care tasks and hearing that all across the country getting into how to fix that I think, it’s really redesigning the practice.
That’s a big task. But we’ve seen that be most successful. It’s not the retreats. It’s not buying a new technology that’s shiny and promises the world. It’s adding medical assistance. It’s adding scribes either in person or remote to create and spread out the work within the practice and there are ways to pay for that.
The first thing you think of when you say adding and adding is cost. With some of the new quality programs out there and some of the new codes, we found ways to have practices pay for some of these new services to spread out the work and make the practice more effective.
And make it more welcoming. Welcoming for staff. Welcoming for the clinicians, welcoming for the patients, improving that patient flow. Getting those scribes involved and really documenting what the clinicians are thinking. Instead of them trying to quickly peck on the keyboard and get a couple things down there so they can get onto the next patient.
Enlarging some of the workspaces and making it more friendly. Having a social worker in the practice where if there’s a need, you can get patients over to the help that they need without the clinicians sitting there going, “I’m not a specialist at this, this patient needs help and care.” And we’re seeing that most commonly in these practices, getting care managers involved with the practice and that helps all the way around. Not only does it take some of the burden off the clinician there with the patient, but it also helps improve their quality metrics.
Patients are being healthier when they’re able to see a care manager, social worker. We’ve talked through giving more vacations or cutting hours, and you’re able to do that if the practice is set up properly for success. You’re not putting all the burden on the clinician to do every single thing in the practice.
We really want to focus on empowering staff other than those lead clinicians to take on tasks they can handle. I think we’re going to see a big boom in nurse practitioners and physician assistants opening practices and taking on more of the healthcare system. I think payers are starting to see that is the future and it’s been great. We’ve seen some really good relationships with not only NPs and PAs and their patients, but also NPs and PAs with physicians and specialists. And we’re starting to see that healthcare ecosystem work in more and more states are opening up full authority for that.
I think interoperability is something that we’ve been promised. Again, I’ve been in the EHR world for over fifteen years and way back then we were talking about interoperability and you’ve got to get an EHR so that you can connect with everyone and you can have all the data available, when the patient’s in front of you and you can make these decisions but yet it hasn’t happened. And there are more and more laws coming down and penalties out there for information blocking. But there always seems to be a way where some of these software vendors are able to block and say, no, I’m not going to share that data, but you can use our add-ons, you can use our dashboards, or you can use our patient portal.
You don’t need to do add-ons. You don’t need an interface. And that’s just not fair because it’s not one size fits all in, in healthcare and there may be a better solution out there for a practice. They’re slowly complying. We’re seeing more and more of these mandates take hold and we’re starting to see some more interfaces.
Unfortunately I think it’s going to be a slow process. I’d love to say we’re going to see this in the next few years, but that’s just not reality. We will see more and more of the larger EHR players push out the smaller and lesser players and dominate, and they’ll be, it seems like once a month now you’re hearing of an EHR vendor buying another.
So we’re seeing consolidation there but ultimately it’s about, changing the way that, that you’ve always done it and doing it in a more modern way where you have more of a team approach and don’t feel like everything needs to be on the shoulders of the lead clinician.
Celina DeFigueiredo-Dusseau: It’s a really great point that you make about the NPs, the PAs, and some of those creative staffing solutions within clinics. While we’re waiting for policies and mandates to catch up with the industry to help encourage those optimal operations in clinics, that is something that can come into play in the short term is having creative staffing solutions to leverage the people and talent in the clinic to help offload some of that responsibility and just make operations move as smoothly as possible while the rest of the industry and the technology works to keep up.
Chad, so some of the data around some of these mitigation strategies and programs are we’re seeing highly positive feedback which is interesting considering how notable the low participation in some of these programs is. Why do you think there’s such low participation in burnout reduction programs?
Is it low interest? Is it lack of awareness or simply just lack of time to even implement these programs in a clinician’s day-to-day work life?
Chad Anguilm: Yeah, I think you hit the nail on the head on that last one. So I think there’s a ton of information out there. And if you Google clinician burnout or provider burnout or burnout, you’re going to see a million different blogs and articles and websites designed around it and more and more things that you can buy and retreats you can attend and a million other things. And unfortunately, it’s time. 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. So I think getting to the point where some of that stuff is possible down the road is our ultimate goal.
And in order to do that, we really have to focus on optimizing these practices and getting patient flow to where it needs to be, getting patient engagement to where it needs to be, and getting staff members to be able to take on tasks that maybe they used to do prior to the EHR but since the EHR was introduced, it’s been on the clinicians. Really balancing the workload back out and getting everyone into a place of work-life balance where you can still care for your patient population.
We’ve seen groups try many different things, joining ACOs. We’ve seen going into concierge medicine, we’ve seen some entrepreneurial groups do that. We’ve had them look into cash pay. We’ve had them look into new payers or even dropping payers that weren’t easy to work with. So we’ve seen major adjustments there but again it’s all around optimizing what you have in front of you and making changes to be a modern practice in using some of the new tools and technology that’s available to be more effective.
Celina DeFigueiredo-Dusseau: So Chad knowing what’s worked and what’s not worked in the field, based on what you just mentioned, what are your predictions of the evolution of burnout in the coming years? You touched on this a little bit, that we’d love to see that drastic improvement in the coming years, but there’s surely a lot of work to do.
Are we at a point now where that we can expect to start seeing some improvement over the next year or so? Or is it still really a struggle to get things under control?
Chad Anguilm: I think we’re still a few years of really working at this, to get to a point where we’re going to be there, be where we need to be.
A big part of that is interoperability. If you’re, again as a provider, as a clinician, if you’re sitting there and you don’t have the data you need in front of you, it’s so frustrating and that just leads to your day, snowballing from there. You’re sitting there and you’ve got your patient in front of you and you don’t have access to their lab results.
It’s really hard to have a conversation with that patient. And again, that leads to just fatigue. By the end of the day, that happens over and over, and as a clinician, you’re like, I can’t do my job without the access to the information. So I think interoperability is huge. I think, we’re seeing that as a major focus. We’re seeing more and more rules coming, with the Cures Act and different things where we’re trying to stop information blocking but that is a slow process. You’re talking really powerful companies across the board from the software companies to the insurance companies that are just making that so difficult on our clinicians.
I think revamping the office, we’re seeing that it’s probably the fastest moving fix to all of this is redesigning your office. Unfortunately, we’re still seeing a lot of lagging when it comes to the payers paying for some of those services that are so necessary. We see programs pop up here and there, but they don’t seem to stick.
There are ways to make it work. Like I said, we’ve worked with some groups that are super successful now due to incorporating care managers and social workers within their practices, being able to work with remote scribe companies, being able to bring on some new employees in the office, being able to utilize technology like virtual front door and being able to empower the patients to do more.
Instead of having them, on the phone all day and taking up three or four of your staff members’ time, directing them to use the patient portal. It’s just so much more effective for communication and really optimizing the portal in the virtual front door so that the patients can actually do more and feel comfortable doing more. And a lot of that is the talk track from the staff members, from the front office, to the clinicians, to the billers of actually engaging with the patients and letting them know, “Hey, use the patient portal”.
You will be shocked at how much you can accomplish without having to call the practice. A lot of that’s just teaching and training, sitting with these different practices every single day. We’re seeing that if you can get everyone to buy in within the practice, the patients surely buy in very quickly.
So I definitely would love to say this is something we’re going to stop talking about burnout within a year. That’s not realistic. We’re definitely getting there, but we’ve got a flawed healthcare system right now, as I mentioned in the very beginning. And because of that, we feel like we’re digging out of a hole and there’s a lot of people fighting for the clinicians. And, we’re definitely one of those groups.
Celina DeFigueiredo-Dusseau: Thank you, Chad. There surely are some industry-wide changes that need to be made to seek a full solution, which can feel a little bit discouraging at times, but there are surely things that can be done right at the clinic level to have a measurable and positive impact in the short term.
Most notably, as you’ve mentioned, leveraging that technology and creative staffing solutions in a way that are engaging and encouraging and supportive rather than further increasing administrative responsibility. We’ve known that go live support and training are crucial to EHR success along and training your trainers, especially super users, are essential in reducing or outright avoiding EHR and technology headaches in your day-to-day operations. It really is important to build trust within your organizational leadership in IT, putting structures into place that give providers a voice in the use of technology, facilitating quick responses to enhance their request, and really just ensuring that all voices are being heard with regard to technology, without increasing the administrative burden of utilizing that technology in day-to-day processes.
With respect to organizational leadership and IT, having that trust in place, having a consistent procedure in place to offer insight and opinion on the use of the EHR and technology in the clinic is absolutely essential. However, the work to actually implement some of those changes, that optimization, the training cannot always be on the provider. So it’s really important to have that structure and that triage in place to know that timely support and adjustments can be made. And notice that there is a measurable impact to that when requests and feedback.
One other helpful approach with respect to decreasing after hours workload and taking that documentation home with you is the use of scribes. Just another creative staffing approach, having scribes in clinic to help offload some of that documentation burden and we can also consider the benefit of sprint events. Rather than having a process for triaging, requests for optimization and input in the EHR, having pointed events or focus with respect to optimization can really be helpful for segmenting focus in optimization. Having a specific topic that requires attention and training, measuring those impacts after a sprint event, and then moving on to something else that may be a point.
Chad, as we start to wrap up here, a little bit, I’d like to hear from you if you have any specific overall thoughts or words of wisdom on where to start. We know that the industry is working diligently at the payer level and the technology company level to implement changes and mandates, but in the short term, what would you recommend clinics focus on to have a measurable and meaningful impact, say, over the next year or two?
Chad Anguilm: Yeah, I think the key is there’s no magic solution. You’re not just going to buy a piece of technology and all of a sudden, you know you’re fixed. I think definitely there needs to be a focus on redesigning the practice. Like you mentioned, there needs to be stakeholder buy-in, everyone needs to buy into the process. I think assessing what you currently have, everything from your workflow and processes to the technology that you’ve purchased and implemented, doing a full assessment on everything.
And going from there, I was in a spot for many years where we were selling EHR technology and many people have asked, Why did you stop that? Why did you stop selling EHRs? Because it wasn’t fixing anything. People were, if you had a problem with one EHR, you had the same problem with the next one, and the same problem with the next one.
And money was just being spent left and right and you weren’t getting anywhere. It was like you were stuck in quicksand and I sat with a clinician one time that says I feel like I’m on my 30 EHR. I’m in the exact same spot I was after purchasing my first, and that’s where we really started focusing on optimization and just aligning everything and ensuring everything connected properly.
And that’s where we get back to the whole, you’re buying the base solution out of the box, and unfortunately, that’s not efficient. So really spending time and focusing on assessing what you currently have in place, have a full assessment done on your practice and then, have an expert that’s been into hundreds of practices tell you, ” This is what I would do to make you more efficient and effective”.
And surely it’s going to mean moving people to different spots and moving tasks all around and rebalancing the workload but that’s where you need to be when you’re talking about redesigning the practice. It’s ultimately moving the workload around and balancing it all out and that’s where we’re seeing the biggest improvement on burnout reduction right now across the country.
Celina DeFigueiredo-Dusseau: That’s great. Thank you, Chad. And the biggest takeaway there that we’ve heard over and over again is that clinician engagement and buy-in from staff across the board, just how critical that is to the performance of any healthcare organization and in particular, ensuring that the providers are well supported must be a top priority in developing any strategy to prevent and reduce burnout.
Thoughtful planning and strategy is absolutely critical. We have to understand the root cause of their burnout, may it be technology and EMRs, the bureaucratic burdens or staffing shortages. It’s sure to vary across every organization, but recognizing and accepting what that root cause might be within your organization has to be the target to identify that root cause and having meaningful impact on wellbeing and engagement in any sort of mitigation strategy.
So thank you Chad, so much for your time and your thoughtful insights today. We really appreciate continuing this conversation and I hope we have the opportunity to dig in even further as we see new strategies come into play and changes happen across the industry.
To our listeners, thank you always for listening and joining in. And as always, we are here. Should you have any questions or wish to learn more. Thank you everyone for your time today.
Medical Advantage Podcast: Thanks for joining us this week on the Medical Advantage Podcast where we discuss the ideas and technologies changing healthcare and what they mean to your organization. For more information, visit us at medicaladvantage.com and make sure to subscribe to the podcast on iTunes, Spotify, or wherever you get your podcast, so you never miss a show.