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Factors that may explain the increase in physician burnout in healthcare

Electronic health records play a big part and the problem is especially prevalent in emergency, family, internal medicine and pediatrics.

Jeff Lagasse, Associate Editor

In just three years, physician burnout has increased from 45.5 percent to 54.4 percent, and it's not because doctors are more depressed or less content at home. They're less happy at work.

These are the findings from researchers at the University of California, Riverside School of Medicine, who listed three main factors that contribute to this increasingly widespread phenomenon.

For one, the doctor-patient relationship has been morphed into an insurance company-client relationship, imposing limitations on the treatment doctors can provide to the insurance company's members.

Then there are feelings of cynicism, resulting from patients no longer expecting continuity of care and routinely changing doctors. The third factor the authors identified is a general lack of enthusiasm for work.

The authors compared data from 2011-14 on physician burnout and satisfaction with work-life balance to arrive at their conclusions. They found that physician burnout measured highest in emergency medicine, family medicine, internal medicine and pediatrics. 

They also posit that five transformational medical practice events that occurred between 2011 and 2014 contributed to the increase in physician burnout: hospital purchases of medical groups, rising drug prices, the Affordable Care Act. pay-for-performance, and mandated electronic health records.

Although all of those factors are important, EHRs are perhaps the biggest contributor, researchers contend. They were initially accepted due to the promise of government subsidies, chartless offices, interconnectivity and higher physician pay.

When the subsidies run out, however, costs can climb. Time with patients is typically less and doctors and nurses spend more of their time in front of computers, decreasing their level of happiness and satisfaction in their jobs.

Other EHR-related headaches include HIPAA-restricted access to outside records, time at home finishing EHR records and unreadable cloned patient notes.

EHRs aren't going away anytime soon, but the authors advise that they not be the focus of a patient's visit. They should reject EHRs that tie up doctor-patient time, as well as ones that use billing diagnoses as opposed to patient assessments.

Twitter: @JELagasse
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