As we make advances in systems and technology there is an underlying belief that increased physician productivity should directly correlate. When we think this way, we falsely assume time management is the only factor and forget to recognize capacity management plays a role too. As a result, burnout shows up far too often. Burnout is slowly undermining the productivity of physicians and their staff. And in recent years, it’s gotten worse as demands from patients, documentation, and regulatory requirements increase.
Compounding the situation include technology advancements and expectations like the need to be virtual, meeting patients where they are, and trying to keep up with constantly changing information in terms of what our patients need and want from us.
Kirk Davis, executive director of operations at Dignity Health, calls it “time poverty.” This can happen a couple of ways as the demand on physicians increases: 1) there is an expectation to spend more TIME in the office, leaving less time with family and 2) there is an expectation to PRODUCE MORE in the same amount of time leaving less energy to bring home to the family. Both tip the scale of work-life balance and lead toward burnout.
What Physicians Do During the Day Matters
Physicians go into medicine because it gives them meaning and a sense of purpose. Yet many feel their altruistic reasons have been replaced with documentation centric as relationships with patients are de-emphasized. Adding to the mix are the challenges of RVUs, which determine reimbursements for services provided, and it’s easy to see how much of the work physicians perform seems unrelated to patient care. They are spending more ‘capacity’ in the same amount of time doing work that drains them vs. fulfills and energizes them.
Distracted Physicians
The application of technology in medicine is similar to distracted drivers and their cell phones. Cell phones are great, but when behind the wheel, drivers should be focused on the road and not texting. This causes safety issues for themselves and those around them.
In many ways physicians and staff are distracted physicians. They have technology demanding them to pay attention to tasks, alerts, and messages. During the pandemic, we added telehealth care, forcing physicians to add another layer of technology to interact with patients. To the patient this may have appeared like a good thing but for physicians, some of them felt less connected to their patients.
Adding to this is the ongoing demands of EHRs (electronic health records) and documentation; it’s no wonder our physicians are distracted. They have reached time AND capacity overload. As a result, more physicians are retiring early, switching professions, reporting burnout and depression, and even committing suicide.
Can Doctor Burnout be Lessened by Technology?
The promise of technology in medicine certainly makes sense. We see it in lots of other industries, making it more efficient to book travel, book a dinner reservation, buy movie tickets or shop online for everything from groceries to furniture.
And yet, in healthcare, the promise of technology hasn’t quite hit it yet for physicians who are behind other industries. Businesses were already conducting video teleconferences, healthcare has lagged behind. Indeed, until COVID, virtual health visits were only utilized on a tiny scale. The pandemic, however, forced physicians to embrace virtual visits quickly. Video conference technology has ultimately made the pathway for patient-provider contact easier for many, but it also puts pressure to complete more patient visits in less time, leaving no room for a break in the day.
Are Algorithms Replacing Experienced Medical Staff?
Technology does make patients safer. Data-driven programs provide predictive modeling, and some physicians use drop-down menus to make decisions. But when do years of training and experience outweigh algorithms? When data replaces experience, and physicians lose the sense that their training and experience are relevant, does it take the meaning from the work? At what point does a physician rely on their training and experience and not the data? We’re still trying to figure that out.
Physicians still treat unpredictable humans who face stressors contributing to their condition that they may not even share and which a computer cannot account for.
As humans, we have this unique ability to take a lot of complex data and bring it together. Yes, computers, technology, and automation can do some of the heavy lifting work. But we need to pair that with our unique humanness. When we do, we arrive at a patient-centric diagnosis versus a generalized answer.
How the Electronic Health Record has Forever Changed Medical Charting
In no place has technology expanded to meet documentation and regulatory demands more than the EHR. From dictation and transcriptionists to voice-to-text, voice-to-transcription into the EHR to the use of scribes—we’re putting technology to work in the EHR.
Technology helps physicians stay up to date on charting instead of working late and from having stacks of incomplete paper charts on their desks. Because all records are a click away, misplaced charts are a thing of the past. Further physicians on call will have access to these charts while at home.
Patients embrace this technology because it’s improving access to care, time spent at the doctor’s office, and it is convenient.
Technology can be our Friend
Yes, technology can support work-life balance for physicians if we use it effectively and don’t allow it to push physicians past the time and capacity boundaries we need to manage and uphold. Technology can make it easier for patients to see their physician and make them feel more comfortable. Technology can help fill staffing shortages. And finally, technology can help physicians work at the top of their license and work with patients in the way we want to.
Technology can be our North star if we understand its gifts to us and its challenges.