The Upside of Change: The Physician Perspective
In many ways, the value transformation will completely disrupt the practice of medicine. But there is an upside.
The volume-to-value shift is expected to have a number of upsides, but curing physician burnout is not usually considered one of them. Intuitively, a disruption of that magnitude seems unlikely to be a net stress reducer.
But for many physicians, the cure for burnout revolves around spending more quality time with their patients. The operative word here is “quality.” Only 27 percent of a physician’s time is spent with patients, while almost half is spent on electronic health records (EHRs) and desk work. That’s where the issues commonly cited as causes of physician burnout come in—i.e., paperwork, data entry, insurance hassles, regulatory compliance, and so forth. I often hear about physicians logging on for hours from home just to keep up with these requirements, and that it provides little or no satisfaction.
Those issues are just contributing factors, though, not the root cause. Physician burnout has been defined as “an erosion of the soul caused by a deterioration of one’s values, dignity, spirit, and will.” That definition speaks to the core of the physician-patient relationship and the need to elevate it, which is where the upside of the value transformation comes in. Physicians practicing in a value-based framework will need to work in true partnership with their patients, which necessitates spending more quality time with them. That’s why some members of HFMA’s Physician Editorial Advisory Board believe that the shift to value could eventually increase physician satisfaction.
Achieving that future state is not going to be easy, however. According to a 2017 study, more than 60 percent of physicians expect high-quality care delivery to get more difficult in the next two years, citing familiar issues such as complex regulations, administrative burdens, and EHRs. To prevent physician burnout, healthcare leaders must look at these issues with fresh eyes. EHRs are a tool for achieving high-value health care, not a vehicle for earning meaningful use incentives or an end in themselves. Regulatory compliance is not another item to cross off the to-do list. The regulatory environment should be continually monitored and onerous regulations that don’t improve value should be changed (and HFMA seeks to do so by working with federal agencies on a regular basis). On the organizational level, administrative tasks should be reevaluated to ensure they support high-value care.
Physicians and finance leaders routinely collaborate on many issues. Many of these issues are intermediate steps on the journey to high-value health care. The journey is long, and it’s easy to lose sight of the ultimate goal. Likewise, it’s easy for nonclinical leaders to look at process issues from a managerial perspective rather than through the physician’s eyes. In seeking to spend more quality time with their patients, physicians are naturally gravitating toward high-value health care. Finance leaders should recognize that and look for ways to support it.
Follow Joe Fifer on Twitter: @HFMAFifer
From the President’s Desk
Joe Fifer expands on his ideas in his September column.