Causes of Physician Burnout

As promised in a prior post, here’s a sampling of issues that are grinding down doctors.  Physician burnout is no mystery illness; we know the causes.  

Electronic Medical Records (EMR).  This modernization of medical data recording has been a true gamechanger for billers and medical coders.  For doctors, it continues to be a source of great angst and frustration.  A few years ago, I was using 4 different EMR systems all at once.  Sound like fun?  It wasn’t.  EMR, despite its advantages, has been a potent force threatening doctor-patient relationships.  How do patients feel watching their doctors pecking away at keyboards throughout most of the visit with hardly any eye contact?  EMR also spews forth hours and hours of tasks and communications (previously known as paperwork)  which are hard for doctors to keep up with.  Readers are referred to the EMR Quality category on this blog for additional rants, I mean commentary.

Demand for volume over quality.  When any worker – professional or tradesman – is tasked to work harder and longer, quality and morale suffer.  This is a mathematical truth.  Ask your doctor how this feels.  As a courtesy, bring alone some antacids as your doctor will surely need some soothing.

Trapped in the coding and billing labyrinth.  I don’t have the space here to detail the complexity involved in deciding what fee to charge each patient.  Many physicians tend to undercharge to avoid being cited and then audited for overcharging.  But we are often called upon to address billing and coding issues which are often beyond our knowledge and siphons away time from actual patient care.

Burned out physicians are looking for a way out.

Insurance company denials for recommended diagnostic testing and medicines.  Yes, there is an appeals process which would drain the strength from a seasoned Navy SEAL warrior.  Recently, I called the Appeals Line to advocate for a patient and hung up after 1 hour and 45 minutes.  Was I too impatient?   Should I have hung on just a little longer?

Administrative torture.  Physicians incinerate many hours each week sorting through e-mails, forms and paperwork, participating in various meetings of questionable value, adjusting to ever changing policies and rules, staying current with compliance requirements, responding to a high volume of patients who contact us each day electronically and enduring periodic upgrades to the EMR.  Is there any way to prune this wildly overgrown tree?

Frustrated patients.  Consumers of medical care have their own legitimate gripes against the medical system.  And many of them are also sick.  Understandably, their justifiable anger and exasperation can adversely affect relationships with their caregivers.  This reality certainly erodes doctors’ professional satisfaction.

The de-professionalization of the medical profession.  This has become widespread as more physicians have become employees.  Physician autonomy is largely non-existent. Physicians’ schedules, time-off requests, staff hiring and work grievances are often subject to the authority of others who are not medical professionals.  If you don’t treat folks as professionals, do you expect that they will feel and act professionally?

In a future post, I’ll offer some ideas on how we might douse the burnout fire.