- Focusing on patient-provider relationships and strategies to address the social determinants of health could help reduce provider burnout, but current care models do not always allow for that, according to the Physicians Foundation’s Biennial Survey of America’s Physicians.
The survey, conducted by Merritt Hawkins on behalf of the Physicians Foundation, included responses from nearly 9,000 physician respondents from different specialties and facility types.
On the whole, the survey painted a picture of an industry plagued by provider burnout, with 78 percent of respondents saying they experience provider burnout to some extent. Inefficiency of EHR use is the leading source of burnout, the survey revealed.
Focusing on patients could be the key to reducing that physician burnout, respondents said. Seventy-nine percent of physicians said patient relationships are their greatest source of job satisfaction, a finding that is consistent with previous surveys.
“What attracts most physicians to medicine is the unique nature of the physician/patient relationship, a fact confirmed by this survey,” the survey authors stated. “The majority of physicians submit to the grueling and expensive grind that is medical education and training primarily in order to play a positive role in the lives of other human beings.”
However, current healthcare models do not allow for this type of patient relationship-building, the survey showed. About one-quarter (23 percent) of physician time is spent on non-clinical documentation. As value-based care models continue to take hold in the industry, physicians are inundated with care quality reporting that gets in the way of their patient interactions.
What’s more, a larger proportion of providers don’t believe value-based care models and subsequent quality reporting has an impact on patient care. Although 47 percent of respondents have their payments tied to value-based care models, only 18 percent think quality metrics are beneficial to patients.
Instead, more than half of physician respondents said quality reporting gets in the way of patient care.
Extensive care quality reporting is contributing to physician burnout, which in turn is leading to an increased risk of a physician shortage. Currently, 80 percent of physicians are at capacity or overextended. That trend could get worse as more physicians plan to decrease their roles in the medical industry as a result of burnout.
Forty percent of respondents said they are considering retiring or cutting back hours in the next three years, up from 36 percent in the 2016 survey. Forty-six percent of respondents said they want to change career paths.
“The primary public policy and healthcare concern attached to low physician morale is the prospect of physicians modifying their practice styles in ways that reduce patient access, or the prospect that physicians will abandon patient care roles or leave medicine altogether,” the report pointed out.
The social determinants of health (SDOH), or the lifestyle and societal factors that influence patients’ ability to achieve wellness, are also top-of-mind for physicians, the survey showed. Eighty-eight percent of physicians said their patients experience at least one social determinant of health. Only 1 percent of physicians said none of their patients experience the SDOH.
Healthcare organizations and physicians are working to address the social factors, but, again, demanding documentation requirements are getting in the way. The prevalence of SDOH and limited resources to address them may be contributing to physician burnout, the survey authors suggested.
“It is sobering to consider the extent to which physicians indicate that poverty, lack of education and other social disorders are affecting their patients,” the report noted. “As referenced above, low levels of physician morale and high burnout are attached to feelings of powerlessness and lack of control, which may result when physicians are unable to materially help patients due to their life circumstances.”
Specifically, SDOH and their impact on patient care outcomes – regardless of treatment quality – could add to that feeling of powerlessness, according to Walker Ray, MD, chair of the Physicians Foundation’s Research Committee.
“It is distressing that such a high number of patients are dealing with one or more social situations that are detrimental to their health,” Ray said in a statement. “These challenges directly impact a physician’s ability to deliver effective care, and the cost implication of these issues is enormous. Such social determinants as they relate to healthcare have been a critical focus of the Foundation for years, and we have made concerted efforts to address these vital issues with partners across the U.S.”
Physicians also experience issues with their patients directly, the survey found. For example, 31 percent of physicians said their patients do not follow their treatment plans.
“In some cases, patients may be unable to adhere to treatment plans, which may include diet improvements, exercise and other lifestyle choices, due to their social circumstances, including poverty and others referenced above,” the survey authors explained. “Some patients simply choose not to follow their physician’s advice.”
Limited patient treatment adherence could be a significant source of physicians’ feelings of powerlessness, as well.
The report did find some highlights to the patient-provider relationship. For example, physicians are increasingly using telehealth technology to expand patient care access. Currently, 18 percent of physicians have adopted telehealth into some of their healthcare practice.
Going forward, it will be essential for medical industry leaders to help physicians overcome the burdens that are impacting their job satisfaction. Creating more space for better patient-provider relationships and making it easier for physicians to address societal factors could help physicians regain control of their own jobs and reduce provider burnout.
“As the patient population continues to grow and to age, and as societal problems such as poverty and drug abuse pose mounting healthcare challenges, it is vital that physicians remain engaged and committed to the practice of medicine,” the report concluded. “Physician satisfaction and physician practice patterns are matters of public health and should be considered as a part of any comprehensive policy to ensure patient access to timely, quality care.”