Medical Economics is a medical industry publication that conducts a physician survey on the primary obstacles physicians face each year. The publication is also referenced by the American Association for Physician Leadership for their white papers, such as those about the patient-physician relationship.
In 2018, Medical Economics asked approximately 300 U.S. physicians about their biggest pain points. The survey included all areas of practice of prescribing physicians, including family practice, ER, hospitals, and private clinics.
According to this yearly survey, the top five issues plaguing physicians in 2018 are:
1. Physician Burnout:
Burnout for practicing physicians is seen in intense physical and emotional exhaustion. Mostly, this is caused by everyday challenges such as busy waiting rooms, cranky patients, dealing with payer rules, etc. The three most telling signs of burnout are emotional exhaustion, depersonalization which can be seen in a cynical and sarcastic approach when dealing with patients, and reduced accomplishment when it comes to offering care. One way doctors might deal with burnout is trying to “remember their passion for medicine” and not letting everyday struggles bring them down. Creating more balance and finding a stress relief such as running or meditating may also work.
2. Time Demands of EHR Data Entry
EHR are electronic health records, which are part of the overall health information technology system. EHRs can significantly improve patient outcomes and overall care delivery. However, it seems that many professionals who are working in the medical field struggle with finding ways to use the EHRs in an effective manner, as it is difficult to divide their time between patients and the computer.
According to the Journal of General Practice, the average doctor spends between 30% and 50% of their encounter with patients looking directly at EHRs. Three simple ways in which physicians can improve their time with the patient while using EHRs are:
• Study the patient’s data prior to meeting the patient to make sure they have the basic knowledge of the patient’s history.
• Copy and paste the patient’s history in the new EHR to “get a head start on the note before seeing the patient.”
• Use laptops on carts in order to be able to look the patient in the eye.
3. The Growth of Uncompensated Tasks
According to the survey, physicians are also plagued by the fact they are spending too much time on uncompensated tasks. It is estimated that almost 20% of the workday is spent going through tasks such as paperwork and prior authorizations. This uncompensated work can cost physicians approximately $50,000 in lost revenue each year. Three common solutions to avoid non-clinical tasks are as follows:
• Physicians should stay away from tasks that do not require a medical license and delegate them to non-clinical staff.
• Doctors should rely on nurses to enter data into EHRs.
• Private physicians should ask the family to accompany the patient for consultations as that way, the doctors are able to bill for the consultation instead of spending time explaining everything to the family members separately.
4. Payer Interference in Patient Care
Third-party payer interference in patient care refers to insurance companies telling doctors how to run their practice and what authorizations they require. One of the doctors in the survey explained, “I don’t get paid extra for the scan, so why does a nurse from an insurance company have to sign off on that? How is that about saving money?”
Physicians are usually struggling to understand the ways prior authorization works for procedures that are often considered to be routine and are meant to be used for low-cost treatments.
Five ways in which physicians can be more efficient when dealing with prior authorizations are:
• Documenting the details
• Knowing prior authorized medications
• Looping in the staff
• Working with payers
• Sharing the criteria with other physicians
5. Managing Quality Measure Incentives/Disincentives
The Centers for Medicare & Medicaid Services (CMS) recently published a rule regarding the Medicare Quality Payment Program for 2018 where the cost category is now at 10% of eligible physicians’ final MIPS score instead of the prior 0%. This change will negatively affect physicians in 2018 as they are already struggling with quality measure incentives and the corresponding reporting when it comes to Medicare.
However, quality measure reporting can be improved as follows:
• Focusing on what the physician does well
• Considering what areas can be improved in everyday practice
• Thinking about the type of clinical care when it comes to reporting
• Understanding the range of quality measures
Source: AskWonder
Works Cited:
1. Top 10 challenges facing physicians in 2018: Pages 1-5, Medical Economics, December 25, 2017.
2. Report on Physicians’ Obstacles Echoes Findings in AAPL White Paper, American Association for Physician Leadership, January 17, 2018.
3. Physician Burnout – 3 Signs and 3 Simple Prevention Steps, The Happy MD.
