Medical Staffing Strategies to Prevent Physician Burnout

Medical Staffing Strategies to Prevent Physician Burnout Medical Staffing Strategies to Prevent Physician Burnout Medical Staffing Strategies to Prevent Physician Burnout Boerner Consider the current workload for todays busy physician: Healthcare reform. Paperwork. Dropping reimbursement rates. More paperwork. Increased patient loads of increasing complexity. Patients who are homeless, without transportation or without money for prescriptions. And yes more paperwork. The diagnosis? Physician burnout. Given that theres pressure on the production end and pressure on the complexity side, its not surprising that physicians experience burnout, says John Combes, MD, president and COO of the American Hospital Associations Center for Healthcare Governance. Survey after survey shows that doctor burnout is growing for GPs and specialists alike. The solution? The right medical staffing that can help doctors focus on what they love doing most treating patients. Start With Teamwork In reality, you cant hire your way out of burnout. You have to be smart about it, says Combes. The issue is how to reorganize care delivery into a much more team-based model, he says, where each professional is working to the full extent of their training. That might mean that, rather than focusing on 2,000 patients, a doctor is part of a team thats responsible for 20,000 patients. Those patients are cared for according to acuity, by the right staff. Heres how it works: A New Physician Role Physicians in this model would handle the most complex or acute cases, handing off maintenance, chronic care and minor illnesses to advanced practice nurse practitioners and handing paperwork to administrative staff. Within this new model physicians play another role as well as temp staff to help prevent physician burnout. Melissa Byington of the medical staffing agency CompHealthheads the companys locum tenens division, which supplies short-term physicians to departments when a physician leaves the team. In the last few years, Byington says more large medical centers are using locum tenens physicians to backfill staff during the hiring process. Finding physicians who are team players, who can easily adapt to new environments and who possess solid workplace communication skills are key characteristics for these roles. They need to be more flexible than most great communicators who fit in immediately, she says. Nurse Practitioners and Physician Assistants Top-performing nurse practitioners and physician assistants, can take some of the patient load off doctors shoulders. Byington says CompHealth has seen an increase in the number of requests for these providers to do exactly what Combes said: To take on more routine tasks so doctors can spend their time on more complex cases. Social Workers In many cases, the provider is tasked with taking care of the social needs of patients, says George Lowe, MD and medical director for two satellite clinics of Mercy Medical Center in Baltimore. Medical assistance at home, government assistance, home care all of these functions fall under the primary care doctors responsibility today. But in Lowes clinics, a social worker is on hand to address these needs, sometimes providing referrals, often doing the work themselves. Counselors/Therapists At the end of the day, most primary care doctors end up being front-line psychopharmacologists, says Lowea role that few physicians feel comfortable with. Lowes model provides licensed clinical social workers trained in therapy to do that work. It reduces stress on primary care doctors because thats another aspect of care that most primary care doctors are not well trained in and feel uncomfortable with, both in training and in time, Lowe says. They dont have 50 minutes to spend with patients on these issues. Medical Assistants At Lowes clinics, each of the 60 physicians and NPs are assigned a medical assistant who does the tasks that drain doctors energy: taking care of paperwork that theyre legally permitted to do, including Family and Medical Leave Act forms as well as forms for durable medical equipment, excepting scooters. Medical assistants also review health maintenance lists for patient follow up; they get medication and test authorizations from insurers. The point, says Lowe, is to reduce the hassle factor that drives doctors out of practice. Community Health Workers (CHWs) These health workers including health coaches, educators and navigators and health case managers connects the dots between physician orders and what the patient hears and does, says Dike Drummond, MD, an executive coach for physicians based in Washington state. CHWs often have little employee training, sometimes only as much as a community college certificate. At the CHW Certificate Program at City College of San Francisco, the oldest such program in the country, they train people to do fundamental care. CHWs learn to speak with patients in their own terms, translating medical terminology into language patients can understand and follow. Health case manager is the most recent role for CHWs, says Alma Avila, director of the San Francisco program. Graduates go to clinics and follow up with patients post-doctor visit. Theyre often the ones who go through directions, she says. If the patient doesnt read, they translate in a way the patient can understand. All of this makes a great deal of sense to Drummond. After all, physicians are expensive, and should spend their time doing what theyre trained to do. Heres the basic lament from all physicians: I just want to see patients, says Drummond. They just want to come in, listen to [the patients] chest, make the right diagnosis and offer effective treatment.