44% of physicians reported feeling burned out (Medscape January 2019). There are many reasons why physicians might experience burnout, but below are seven of the more common causes along with how OutcomeMD helps.
Increased utilization of subjective online reviews has created space for blackmail to enter the doctor-patient relationship. Physician’s online reputations can be damaged by a patient who, for example, is unhappy that they had to pay their copay, or didn’t get the prescription they wanted, or didn’t like front office staff, none of which has anything to do with the doctor’s ability to deliver a good outcome to the patient. In fact, 72% of the patients who are unhappy and who post negative feedback on Google and Yelp are not doing so because of the patient- physician experience (reference). . And higher patient satisfaction has been correlated with higher mortality. Doctors in America must satisfy their patients in order to maintain a profitable business, which is to say that, in many cases, they need to cater to patients desires rather than specifically focusing on delivering the best care possible.
Doctors simply don’t have time to adequately measure a patient’s symptoms and quality of life burden that they carry as a result of their medical condition. One study showed that the average doctor interrupts a patient after 11 seconds (reference 1) (reference 2). Providers cannot be expected to ask the perfect, literature-validated questions for every condition they treat, and they certainly can’t be expected to quickly calculate the array of different formulas required to properly score the patient’s responses. They also don’t have an easy real-time way to understand how similar patients responded in the past to the various treatment options.
Patients don’t have objective ways to find doctors, so many admit that they don’t inherently trust them. As a result patients sometimes ask their providers to explain why they should choose them for their care. They may ask how many times have you done this treatment, or can I speak with a previous patient of yours as a reference? These interactions may be standard in business, but can be quite uncomfortable for providers.
Providers are pressured to thoroughly document their evaluation and thought processes during the patient visit. This results in a major disconnect during doctor-patient interactions, as eye contact is often a thing of the past; the computer screen and keyboard win. If clinicians do not adequately document they can have a hard time defending themself in an audit or lawsuit. These pressures can make providers feel like they cannot adequately focus their time and effort on communicating with patients in a connected, meaningful way.
Providers are often required to speak to payers to defend their requests for patient treatments and services before they can be approved. This process is time consuming and extremely frustrating for providers. The pre- approval requirement stems from the fact that doctors often order unnecessary tests and treatments in an attempt to cater to patients, as discussed above, and from the fact that payers have no objective way to know that a provider makes sound medical decisions.
In order to maintain board certification most clinicians must pay large sums of money to their respective Boards, and take regular academic tests or collect and deliver patient records in difficult to compile formats. Doctors should practice evidence-based medicine, but the system does not make it easy to inform decisions as the medical literature can be flawed with bias and underpowered studies that may not relate to the specific patient phenotype of the individual who the doctor may be treating. Maintenance of board certification is yet another reason that it can feel exhausting to be a provider.
It’s only an art of medicine because there's not enough science, but many doctors resent decision support tools that are based on old meta-analyses from the medical literature that may not specifically apply to the patient sitting in front of them. They often feel like their clinical instincts are being undervalued, which of course makes it less enjoyable to practice medicine.