Unhappy physicians linked to patient safety risks

Dissatisfied physicians are like a canary in a coal mine: an early warning sign for healthcare systems that they may have problems that can affect patients and their safety, says Mark Friedberg, M.D., in a perspective piece published by the Agency for Healthcare Research and Quality's Patient Safety Network.

Healthcare leaders must consider physician professional satisfaction as an indicator of their health system's performance, says Friedberg, senior natural scientist at the RAND Corporation in Boston. "Proponents of this idea, including me, believe that when a group of physicians is dissatisfied, stressed, or burned out, the key step is to investigate why these physicians are so miserable. If the underlying causes of physician dissatisfaction also seem likely to threaten the safety of patients and quality of care, these factors may be high-priority targets for remediation," Friedberg writes.

What specific factors contribute to unhappy physicians? Leaders who ignore physicians' ideas for improving patient care, payers who refuse to cover necessary services, practice models that did not foster collegiality with other providers, schedules that prevent doctors from spending enough time with each patient, and mandated activities that distract them from patient care, according to Friedberg. He also noted that many were also frustrated with electronic health records that can undermine patient safety. That's backed up by one recent study that found 1 out of 5 providers were so burnt out by the EHRs preventing them from doing their jobs they were ready to "call it quits."

Friedberg urged leaders to ask physicians about what is and isn't working and about the obstacles that prevent physicians from providing optimal patient care in their practice. Instead of dismissing physician complaints as whining or looking for quick fixes, good leaders will look for solutions and make sure they work, he said.

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