InCrowd conducted two physician surveys to help expand the discussion around burnout and understand possible solutions. Read the first two posts in this series:
“A New Survey Unlocks the Human Experiences Behind Physician Burnout.”
“Burnout Exists at High Rates Regardless of Practice Setting or Years in Medicine.”
Alarming numbers of doctors are burning out. That’s been the takeaway from two recent InCrowd micosurveys of 518 PCPs and specialized physicians in private practice, clinic, and hospital settings. More than half (57%) reported experiencing some symptoms of burnout: exhaustion, frustration, lack of motivation and resentment toward their employers and patients. Another 37% said that while they are faring better, they’ve witnessed signs of professional fatigue in colleagues.
Making matters worse, the top reasons cited for such widespread dissatisfaction — increasing demands on doctors’ time to deal with insurance companies and electronic record-keeping mandates — are deeply entrenched in the healthcare system. There are no quick fixes here. But when we asked doctors how they cope, and what workplace adjustments would improve their performance and well-being, they offered tangible solutions.
The top three suggestions from our respondents were mandatory vacation or half days, reduction of patient volume, and increased staffing (nurses, medical assistants and administrative assistants).
General agreement among rookies and veterans
The prioritization of these suggestions varied only slightly with experience. A majority of respondents (53%) with 10 or fewer years of practicing preferred increased staffing over the other options. Among those with 11-20 years in medicine, 52% advised that mandatory vacation and half days would be the best choice. Doctors with more than 20 years on the job leaned toward reducing patient volume (47%).
Preferences also shifted when viewed by setting. Nearly six in 10 doctors who work in either academic or community hospitals chose increasing support staff as the single best option. Private-practice PCPs ranked reduced patient volume highest.
We also asked respondents what advice they would offer to current medical students. Just over one-third emphasized always striving for work-life balance. “This is a marathon, not a sprint,” noted a PCP from Florida. “Make time for family/friends and hobbies.”
Of course that’s easier said than done for people who have dedicated their lives to helping those in need. But boundaries are essential, and 14% strongly recommended seeking employers with mandatory time-off policies. “Set limits on how much you are willing to work and stick to it,” advised an oncologist from Indiana. “Take all the vacation time you’re allotted. Don’t take work home — home time is your time.”
“They should join a group that limits patient volume and allows them to take a full day off during the week,” added a dermatologist from New York with more than 20 years’ experience. “It’s a topic that physicians have not addressed much in the past; physicians were expected to always be available to their patients.”
Could Direct Primary Care be the answer?
Many who responded to InCrowd’s microsurvey recommended direct primary care (DPC), an emerging model for healthcare provider compensation. DPC replaces the longstanding fee-for-service model with a flat monthly fee that covers comprehensive primary care services. With no insurance companies involved, time spent on administrative duties can be reallocated back to patients.
“The ability to cut the red tape, focus on patients, have time with patients and make a higher than average salary are all key factors to avoid burnout,” states a doctor form Kansas who uses DPC. “Even when I’m busy, I can still enjoy my work [because] it’s almost all direct patient care or patient-related.”
Another physician practicing at a DPC facility in Wisconsin provided specifics: “Our patients pay a small monthly rate, $10-100 per month for unlimited care. The physicians manage a panel of about 600 patients and are salaried at $200k/year and see about six patients per day. The improved time with patients and the efficiency all help the physicians to avoid burnout.”
Unfortunately, DPC is not available to all physicians. So far, only 16 states have adopted legislation exempting DPC from insurance regulation, an important step, according to the Direct Primary Care Coalition’s web site. (http://www.dpcare.org) In the meantime, burnout remains a serious concern.
As a PCP from Kentucky explained, “This is a systemwide problem, and it will not be easily solved with one or two changes. Physicians need to feel back in control of their lives and actively caring for patients instead of being made into highly paid data entry clerks and bureaucratic lackeys.”
InCrowd will continue to report on this important issue.
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