From The Happy MD
By Dike Drummond, MD
Every time you survey a group of physicians on their biggest stressors, Electronic Medical Records is a clear #1.
Why is that? Why are the implementation of electronic medical records and the dramatic increase in physician burnout synchronous?
In my work with over 140 healthcare organizations to date, the answer is plain as day on nearly every job site I have visited:
This is simple OVERWHELM - in the front lines of patient care, there is too much work and not enough hands on deck
The whirlwind of EMR has destroyed many physician's ability to be effective at the point of care. It is a constant distraction to quality decisions, effective communication and a clear threat to the health and well-being of the physicians and their staff members.
Electronic Medical Records and other sources of digital overload (texts, email, patient portals, cell phone apps) have changed the nature of a physician's work and massively increased the number of tasks at the point of care. Studies show doctors spend up to two hours in the EMR for every hour of face time with patients.
It would be No Big Deal if the healthcare industry had done the most appropriate thing ... increased staffing levels to handle the increased workload. With rare exception, employers have simply dumped the data entry responsibilities on the doctors and other front line staff.
This is a completely avoidable crisis.
Ineffective management of digital overload has turned EMR into a Physician Burnout Issue ...
when it should simply be a Staffing Issue !!
Here is the Effectiveness Formula:
Effectiveness = Results/Effort
(adapted from "The Effective Executive", Peter Drucker)
If you double the time and effort required to provide quality care, you have just cut the physician's effectiveness in half. A significant number of your doctors will struggle and/or burnout when overwhelm like this is a normal workload. The modern tsunami of clicks and keystrokes that is the Electronic Medical Record begs a simple question ...
Do you want your doctors to take good care of patients
Or do you want them to be top notch data entry clerks?
Stop blaming the victims and choose one or the other
Burnout is the Result if you Try To Have Both
Yes, there are physicians who love EMR and would never go back. These are the Power Users and they are a rare breed. You cannot have a healthy workforce if only 15% of your providers are proficient in your documentation software.
There is always a significant percentage of doctors who feel the Electronic Medical Record is their #1 stressor at work. These same hard working 40 - 60% of your physicians are are sick and tired of putting in dozens of hours a week at home after the kids are in bed, just to keep the digital beast at bay.
This wouldn't be such a big issue if most healthcare organizations asked the Quadruple Aim question at some point in the last decade:
"What will this do to the health and well-being of our people?"
We should have seen this coming years ago and completely avoided this crisis. It is a simple conclusion that if we double the work and don't increase the staffing, something would have to break. What we broke was the physicians.
It does not have to be this way
Team Care protocols are showing that every one of the negative effects of task overload and burnout can be reversed. All you have to do is staff up to the work at hand. "Super MA's" and true team based care are two of the keys.
Two specific examples of workplaces that have minimal burnout and overload and maximal throughput and financial performance are:
I encourage you to study their team care protocols and implement a pilot project in your organization ASAP. The benefits of appropriate staffing levels are obvious for everyone on the care team. Forward thinking organizations are already working to implement team based care workflows like these ASAP. It can't happen fast enough.
Until the staffing in your ward/wing/service is a match to your workload, make sure you tweak your EMR Strategy to minimize your stress levels.