There’s a big gap between what physicians want to do and where they actually spend their time, which means it's time to redesign the role of doctors, write two physician leaders in a piece for the Annals of Family Medicine.
Doctors spend less time on activities such as developing caring relationships with patients and using their intellectual and technical skills to help people, and instead devote a substantial amount of time and energy doing data entry and forced function work, write David B. Reuben, M.D., at the Geffen School of Medicine at UCLA, and Christine A. Sinsky, M.D., vice president of professional satisfaction at the American Medical Association.
When doctors are disconnected from the needs of patients, they experience career dissatisfaction, with the majority of physicians now exhibiting signs of burnout. Without changes, doctors will continue to experience job dissatisfaction. Research last year showed that burnout has led 1 in 5 doctors to plan to reduce their clinical hours. And roughly 1 in 50 plans to leave medicine altogether within the next two years.
Reuben and Sinsky write that it’s time to redesign doctors’ roles so they shift from current unfulfilling transactional tasks to focusing on providing personalized aspects of care. To align the practice of medicine with the mission that motivates physicians and create satisfaction, they suggest the industry:
1. Shift responsibility for many transactional aspects of care, such as providing most guideline care for preventive services, data gathering and entry, and documentation to other clinical professionals and staff.
2. Ensure physicians play a larger role in personalized aspects of care, such as customizing care for individual patients and working together with colleagues to help their mutual patients.
3. Make needed changes at all levels, including medical education, individual physician, delivery organization, technology tools, policy and payment systems. For instance, medical educators will need to teach physicians better oral and written communication skills for caring for patients. At a policy level, performance measures must focus on providing care for patients and payment systems must be revised to compensate doctors for care within and outside the visits.