A study from earlier this year from Stanford researchers highlighted the severe consequences of burnout in healthcare.
“We found that physicians with burnout had more than twice the odds of self-reported medical error, after adjusting for specialty, work hours, fatigue, and work unit safety rating,” they explain. “We also found that low safety grades in work units were associated with three to four times the odds of medical error.”
Sadly, despite the extreme consequences of burnout, it’s something that appears to be on the rise, at least according to a recent paper from the University of California, Riverside. The paper revealed that burnout among physicians had risen from 45.5% to 54.4% in just three years.
The authors outline three main reasons for this increase in burnout:
- They suggest the doctor-patient relationship has been replaced by an insurance company-client relationship. This places significant limitations on the treatment doctors can provide.
- A rising sense of cynicism due to the changing expectations of patients.
- A lack of enthusiasm for the work.
The findings emerged after data on physician burnout and satisfaction with their work-life balance between 2011 and 2014 was analyzed. The data revealed that burnout was highest in areas such as family medicine and emergency medicine. Whilst the aforementioned reasons are high on the list of contributing factors, the industry also went through a number of significant changes during that timeframe.
“These are hospital purchases of medical groups, rising drug prices, the Affordable Care Act, ‘pay for performance’ in which providers are offered financial incentives to improve quality and efficiency, and mandated electronic health records,” the authors explain. “Doctors now spend more time with electronic health records than they do with patients. Electronic health records were pushed by the government at great expense and without regard to the effects upon patient or physician health. Go into any hospital and look for the nurses and the doctors. You will find them sitting in front of computers. They are not happy, and their patients are not healthier.”
The introduction of electronic health records has been a particularly interesting development. I’ve written before about the dissatisfaction with which many doctors view the technology, as they feel it takes the face-to-face contact away from consultations. The paper also reveals that the technology tends to erode work-life balance, whilst also providing unreliable records.
“EHRs are not going away, but they don’t need to be the focus of the patient’s visit,” they explain. “Doctors should oppose EHRs that occupy valuable doctor-patient time and which use billing diagnoses rather than patient assessments. EHRs need to be portable. Computerized notes should be templated for meaningful patient care notes.”
As technology is ostensibly designed to support our work, I suspect that things like electronic medical records won’t really take off until they are capable of recording notes automatically via the voice conversations the doctor has with the patient so that useful records are taken but the doctor-patient relationship is maintained. With all the developments in AI in healthcare, perhaps this would be the development with the greatest impact.
