Redesigning medical practices can cut physician burnout

Physicians have challenging and often brutally taxing jobs. What can they do to avoid getting burned out and possibly leaving the profession?

According to Medscape, quite a bit. In an interview with Christine A. Sinsky, M.D., an Iowa internist and vice president for professional satisfaction at the American Medical Association (AMA), redesigning the workplace can go a long way toward lightening the non-essential workload of physicians and making their days less challenging. Sinsky is heading up the AMA's STEPS Forward initiative. She is borrowing some of the things she learned when she helped redesign workflow at her own 170-physician practice in Dubuque, Iowa.

"We systematized anything we could, so that the right things happened by default," Sinsky told Medscape. "We delegated work to the most appropriate person and eliminated unnecessary work whenever possible."

Physician burnout continues to be a mounting concern; data from late last year suggests it is on the rise, putting more pressure on a profession that is already experiencing a shortage of clinicians.

One of the biggest changes is having doctors delegate tasks to other clinicians such as nurses and physician assistants. Consider reassigning tasks such as administering immunizations, updating medical histories, reconciling medications, making minor diagnoses (such as strep throat or STIs) and setting up preventative care services. Standing orders can be issued by doctors to ensure that no one is straying into areas beyond their licensure, according to Medscape. Doctors can also be paired with two other clinical staff members to ensure they get the proper training.

Not only does this lighten the workload on the physician, it can make the practice more efficient, allow for more patient visits and even generate more revenue: Up to 30 percent in some cases, according to Medscape.

Clerical document assistants can also be used to update electronic health records. And work schedules can be staggered to accommodate a physician's personal life, or even changed to allow a physician a temporary open “desktop” slot that would allow them to catch up on paperwork and other tasks that don't include seeing patients.

Such changes require working closely with medical practice and hospital administration, as well as having open channels of communication with doctors to determine what specifically is stressing them out and how it can be best addressed.

After years of griping by doctors that hospitals were not listening to their concerns, some have begun to opening up paths of communication. The Mayo Clinic, for example, holds dinners with the medical staff to determine which components of their work are causing stress.