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Medical Group Management Association

Leveraging Advanced Practice Providers to Mitigate Physician Burnout: Opening Multi-Specialty Surgical Practice in Medically Underserved Areas

Fellowship Paper - September 14, 2021

Marcus Bobbitt PhDc, MiM, FMC, FACMPE
Physician burnout has been discussed for decades yet continues to rise year over year. Recent studies suggest that physician burnout has surpassed crisis proportions and reflects a continual increase in the frequency of emotional fatigue, depersonalization, and or mental and exhaustion. One study conducted by AMA suggests that more than half (56%) of physicians experience burnout syndrome, which negatively impacts patient relationships, patient records, and physician self-worth, ultimately resulting in physician derailment, absenteeism, or severe cases, suicidal thoughts or actions. Medscape physician burnout and depressions survey identified the top ten contributors to burnout, most of which surround administrative tasks, which in their view, absorb valuable time, which is better spent with patients.

Over 55% of the population experiencing physician burnout contribute 'patient charting' and EMR use the top cause the burnout syndrome.  More sharply, a recent study published by The New York Times suggests that physicians spent an average of 54% of their time charting notes on patients seen. The analysis concludes that charting per patient takes longer than the clinical visit itself. Diving deeper, the Medscape National Physician Burnout & Suicide Report of 2020 states of the millennial generate, generation X, and boomer generation, over a third of each generation would, on average, forego between ten thousand and twenty thousand in compensation dollars in exchange for 20% fewer work hours. Of the generation X category, they are willing to forego between a staggering twenty and fifty thousand in compensation in exchange for fewer work hours.

Nonetheless, the following proposes the creation of a new business with an operational structure that leverages an Advanced Practice Provider (APP) such as a physician assistant or nurse practitioner. More sharply, the business plan structures the APP to suppress and mitigate physician burnout while building a multi-discipline practice. Although the critical components of opening a practice are also demonstrated through the business plan, the approach intertwines advanced practice providers in a clinical setting. In theory, it provides the physician more time with patients and less time charting within an EHR during the visit. Moreover, the top three causes of burnout are EHR, charting, and long hours. The following proposal outlines a model where the APP role is structured to perform the majority of the clinical visit notes, consult notes, discharges, medical management, and conducting the clinic. All of the previously mentioned tasks will conceivably save the physician time, provide autonomy to the APP, and in theory, mitigate top contributors of physician burnout. This approach serves as an organizational-level strategy to address the growing health crisis from a human resources perspective.

The model also proposes a financial structure where the APP can help compensate for their associated labor / overhead costs by incident-to billing and surgical assist fees. Furthermore, in theory, when the APP is incentivized both monetarily and psychologically, the APP is provided structured autonomy and increased compensation as the physician hedges top causes of physician burnout.

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About the Author

Marcus Bobbitt
Marcus Bobbitt PhDc, MiM, FMC, FACMPE
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