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Battling Physician Burnout

In an ambitious initiative, The US Oncology Network is getting to the root of physician stress.

Here’s an uncomfortable fact: physicians experience higher rates of burnout than nearly any other professional population. Burnout is marked by symptoms of emotional exhaustion or depersonalization (a callousness towards others) that occur at least once a week. The American Medical Association estimates that about 45% of physicians experience some form of burnout.

Dr. Michael Seiden, president of The US Oncology Network (The Network), understands why some may find this hard to believe.

“Doctors are in a proud profession. They’re saving people’s lives,” he explains. “They probably have less financial stress than many other groups. Unfortunately, they also have the highest suicide rate of any professional class, as well as high rates of alcoholism, depression and divorce. Burnout is a big problem, and statistics suggest it’s only getting worse.”

Going in, many oncologists don’t fully grasp the challenges of delivering care – stringent regulations, payer scrutiny, voluminous electronic health records, the demands of documentation – until they begin the practice. Those pressures can erode the sense of purpose, empathy and idealism that brought them to the profession in the first place.

A Multi-Phased Response

A doctor takes a break during a busy shift  

In our quest to improve patient health outcomes, the wellbeing of providers can sometimes be overlooked. To counter that, The Network launched a pilot in 2018 to promote and improve physician well-being. As part of Phase I of this initiative, designated staff helped identify wellness initiatives for their practices. Additionally, the core team of physician leaders and staff developed the Clinician Wellness Playbook and the Resiliency Guide and rolled them out to all practices across The Network.

They also measured burnout rates to confirm their starting point and identified key causes of burnout to align their resources with what the providers need.

One of the most significant findings from Phase I is that the leading cause of burnout among physicians is charting requirements. Today, providers spend an inordinate amount of their workday on clerical tasks and updating electronic health records.

“We learned that the physician is spending greater than 50% of their time with the patient staring at a computer and entering data in the electronic health record,” says Dr. Seiden. “When they said, ‘I want to be a doctor,’ it wasn’t to improve their typing speed or look at a computer screen. They wanted to look at people.”

According to Dr. Loren Rourke, chief surgical officer for The Network who oversees the pilot, that screen time can mean up to 30 additional hours – outside of office hours – in a physician’s work week.

“Believe it or not, charting has become so arduous, some doctors almost avoid seeing more new patients because of it,” she admits. “For cancer patients, that’s precious time they now have to spend finding a doctor who can fit them in.”

A Bold Solution

Phase II of the physician wellness initiative begins this summer. During this phase, The Network will assign scribes to a pilot site to learn how much they can alleviate physicians’ workload. Scribes are paraprofessionals who specialize in charting physician-patient encounters in real time. They also locate information for physicians and complete forms needed for patient care.

In-person scribes were studied in Phase I of the pilot, and the results were promising.

“When we interviewed managers after the scribes had been there a while, we found that morale in the entire clinic improved,” says Dr. Rourke. “Everyone, from the nurses to the schedulers, said they had increased job satisfaction by the sheer fact that the doctor came in that morning in a good mood.”

Burnout doesn’t just impact clinicians. It can hurt morale within their practice and contribute to higher turnover rates. According to Stanford Medicine, burnout-related turnover costs the nation $5 billion annually.

Scribes may also prove valuable in recruitment.

An image of a doctor's hands charting on a computer  

“There’s a shortage of cancer caregivers in the country,” Dr. Seiden explains. “We want practices in The US Oncology Network to be the best places to work. If an oncologist is being recruited by hospitals or other clinics, we’d like them to say, ‘The Network cares about us at this practice.’”

Richer data collection is another potential outcome of adding scribes to The Network. Data is central to building our integrated oncology services – especially for Ontada, our oncology data and technology business. As Ontada advances ways we can apply data to answer some of the biggest questions in oncology, scribes could fill in optional fields of data that a time-strapped doctor might skip.

“If we scale up the scribe program, we can potentially capture more about the patient’s medical record because someone else is inputting the data,” Dr. Seiden says. “The better the clinical data Ontada collects from these health records, the better our research into and understanding of evidence-driven clinical – or treatment – pathways.”

And with physicians spending less time filling in optional fields, the hope is that they can spend more time doing what they’re called to do – interacting with and treating patients.

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