Several readers commented about the disruption of revolving door members of their professional health team – those leaving a practice, with or without notice. One asked, why can’t organizations keep compassionate people-centered professionals? A good question. It takes time and effort as an e-patient to develop good relationships with professionals. When my clinicians have moved on, I am greatly stressed and my health is challenged. I was at a meeting recently of the Lown Institute, a predominantly physician group of burnt out or burning out docs committed to people-centered care. The main beef seemed to be with administrative burden / electronic record edging out face-to-face time between people and clinicians.
An editorial published in the Journal of General Internal Medicine reported burnout rates ranging from 30% to 65% across specialties, with the highest rates incurred by physicians at the front line of care, such as emergency medicine and primary care. The 2015 Medscape survey results reflect this same pattern, with the highest burnout rates found in critical care (53%) and emergency medicine (52%), and with half of all family physicians, internists, and general surgeons reporting burnout. Of even more concern, among internists and family physicians who responded to the Medscape survey, burnout rates rose from about 43% in 2013 to 50% in both groups, an absolute increase of 7% but a 16% rise in incidence in just 2 years. Reasons include too many bureaucratic tasks and increased computerization. Interestingly, the question of what to do about it was focused on efforts to reduce individual stress and not system solutions to reduce bureaucratic tasks and increased computerization.
As you know, my passion is the experience of people at the center of the health journey. Hard to improve anyone’s experience without improving the experience of the whole team. Unfortunate that work flow / life flow, productivity, and technology are at cross purposes. Seems like the quadruple aim (individual experience, provider experience, population health, and community cost) work best when all aligned. This is a nut we haven’t cracked yet. Mostly we work on a piece, not the whole. Unfortunately, public policy, public opinion, business practice lags far behind unhappy people and burning out professionals. How can we, people at the center, take care of our person-centered professionals so they stay with us?