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    Robert C. Bohlmann
    Robert C. Bohlmann, FACMPE
    Disclaimer: MGMA does not endorse any solutions put forth in this column. We urge readers to explore the legal issues — federal, state and local — that might arise from a particular course of action.

    I have heard several disturbing conversations in hallways of healthcare environments and social gatherings of healthcare professionals that burnout among physicians is a growing problem. Some healthcare leaders have acknowledged those signals yet there is little or no distinctive response. 

    What I want to say to my colleagues is that I hear you, and I call on our healthcare leaders to respond to this important call for help.

    While burnout is discussed in a growing number of environments, I believe it is important to acknowledge the issues that feed this sense of discouragement, such as government compliance and health plan mandates.

    My physician colleagues have identified a number of negative pressure points. But while everyone in the healthcare system notices them, I don’t see any effort to quantify the degree of their effects or to resolve them. 

    Realities

    Here are a few questions I hear when I talk with my physician colleagues:

    • Should I reduce my patient schedule or add additional hours to catch up at day’s end?
    • If I use nonphysician providers (NPPs), what role should they play? How will I be compensated for the time I spend with them?

    Patients are affected by physicians’ busy schedules and increasing information technology (IT) requirements that result in the following complaint from doctors: “I seem to spend more time on data entry and pursuing health plan approval than actual patient contact. Yet our goal continues to be provision of quality care!”

    These pressures to see more patients and adhere to IT requirements have resulted in a loss of personal income, affected professional satisfaction and mental well-being, and led to early retirement. They have also prompted some tenured doctors to dissuade aspiring doctors from pursuing medicine as a career. 

    More patients

    As the industry attempts to care for an estimated 31 million new patients and recognizes an increasingly limited supply of providers, healthcare administrators must start to ask and answer serious questions about how to address burnout, what should be done to add to the pipeline of doctors and NPPs, and how they can alleviate some of the pressures that exacerbate the issue. 

    To jump-start the conversation, I would pose the following questions that pertain to the economic effects of physician burnout on the industry:

    • How have health plans helped offset the costs of additional patient work? 
    • Has the influx of patients from the Patient Protection and Affordable Care Act contributed to higher costs? If so, how has this affected the morale of the doctors in your practice?
    • What type of help have you enlisted from scribes or additional staff to accommodate the influx of new patients? How do you acknowledge those contributions in terms of compensation and recognition?
    • As ownership of physician practices shifts to a greater influence from big business and government, is there a concern about an Orwellian influence on the healthcare system?

    I am increasingly concerned about physician burnout and the effects it has on our industry, which is why I have written this column. I hope to hear more dialogue about solutions to this issue in the coming months. I started my healthcare career in 1965 and have seen many changes in the industry. But physician burnout has the potential to derail the industry in serious ways. 

    I have interviewed physicians to gain their perspectives on this important issue, which I have included in this piece, and I call on healthcare dyads to jump-start the discussion that will lead to solutions. Physician and administrative leaders are in the unique position to initiate meaningful changes that will help alleviate and eradicate burnout among physicians. The time to act is now. 


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