Mitigating Physician Burnout
EMRs are abusing doctors and are the primary cause of physician burnout.
EMRs are abusing doctors and are the primary cause of physician burnout, according to American Medical Association (AMA) President Barbara McAneny who made the assertion at a November 2018 AMA Interim Meeting. She went on to say that EMRs are turning physicians into data entry clerks.1
The pressure on physicians to pack more patient appointments into a hectic day and then complete paperwork long into the night is resulting in high levels of burnout. According to the Agency for Healthcare Research and Quality (AHRQ) some studies have found that half of physicians suffer from some form of burnout.
The AHRQ says that the “burnout factor” has begun to impact patient safety, quality of care, and access to care as physician retire. Key causes of burnout include time pressure, family responsibilities, chaotic environments, low control of pace, and the use of EMRs.2 A survey by The Doctors Company revealed that every hour a physician spends directly caring for a patient results in two hours of EMR data entry and related tasks.3
Researchers found that practices that implemented electronic health records saw an increase in stress as EHR use matured…additionally, fully mature EHR systems, especially with shorter visits, were associated with physician stress, burnout, and intent to leave the practice.
Cost of physician burnout
A recent study revealed that physician burnout costs the healthcare industry between $2.6 billion and $6.3 billion each year with a baseline of about $4.6 billion in costs from turnover, reduced productivity, and other burnout-related factors. The study also found that each physician suffering from burnout costs his or her facility about $7,600 annually but could rise to as high $11,000. These numbers don’t account for indirect costs that are hard to quantify like revenue loss, loss of reputation, disruption to patients and the care team, and less favorable contracting with payers.4
I am hearing more physicians become completely demoralized by what (the EHR) has done to their ability to really provide the kind of personalized and quality patient care (they wish to give patients)
Ergonomic impact on burnout
In addition to the demands of excess data entry, the layout and ergonomics of the exam room also play a part in physician burnout. A recent study on the use of health information and communication technologies (HICT) published in JAMIA Open identified ergonomics as a key stress factor. Many survey respondents reported headaches, wrist, neck, back and eye strain as a result of HICT use. One participant reported suffering from “mouse shoulder” while another said she spent $2,000 to find the correct eyeglasses to reduce eye and neck strain. Other reported issues included constant workstation adjustments leading to sleep difficulties and anxiety.
One of the key criticisms of current HICT use was ergonomic problems due to legacy clinical architecture poorly retrofitted with HICT equipment. The survey suggested several ways to deal with ergonomic problems in the clinical workspace including deploying architectural designs that consider modern clinical workflow. The survey found that proper height of the computer monitor can reduce stress levels and enhance user comfort and performance.5
Another study noted the difficulties of fitting modern computer workstations into older facilities where exam rooms were not designed to accommodate the HICT infrastructure. Inability to properly set up monitors and input devices can cause physical discomfort for the provider – creating another cause of dissatisfaction and burnout.6
Designing workstations to minimize stress
Providing ergonomically correct workstation design can be extremely beneficial for providers. A study involving 86 healthcare facilities in Ohio showed that ergonomic consultation and ergonomic equipment significantly reduced the occupational musculoskeletal disorder (MSD) rate from 12.3 to 6.6 per 200,000 employee-hours.7
StableRise® has been installed in medical centers across the U.S. and provides the properly designed workstation support critical to providers. StableRise equipment is easier to use and adjust than wall-tracks, thus ensuring optimum ergonomics. Ensuring a comfortable working environment enables physicians to focus on providing patient care and, over the long term, can help reduce the physical stress that contributes to long-term physician burnout.
I also spend all my time in the clinic trying to adjust my chair up and down and adjust the monitor. Some of them go up and down and some of them don’t, so I …run around the clinic trying to find which monitor I should sit at (and) to move chairs around trying to find the right chair. I spend some time doing that and I still go home with neck spasms…
Respondent to survey published in JAMIA Open
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- EMR Effect on Quality of Care Still a Concern, Can Be Addressed, Relias Media, January 11, 2019
- Physician Burnout, AHRQ website
- Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties, by Christine Sinsky, MD; Lacey Colligan, MD; Ling Li, PhD; Mirela Prgomet, PhD; Sam Reynolds, MBA; Lindsey Goeders, MBA; Johanna Westbrook, PhD; Michael Tutty, PhD; George Blike, MD, Annals of Internal Medicine, December 6, 2016
- Physician burnout costs industry $4.6B annually, by Rebecca Pifer, Healthcare Dive, May 28, 2019
- The electronic elephant in the room: Physicians and the electronic health record, by Philip J. Kroth, Nancy Morioka-Douglas, Sharry Veres, Katherine Pollock, Stewart Babbott, Sara Poplau, Katherine Corrigan, Mark Linzer, JAMIA Open, Volume 1, Issue 1, July 2018
- Ergonomics Concerns and the Impact of Healthcare information technology, by Alan Hedge, T. A. James, Sonja Pavolvic-Veselinovic, ResearchGate, July 2011
- Ergonomics Concerns and the Impact of Healthcare information technology, by Alan Hedge, T. A. James, Sonja Pavolvic-Veselinovic, ResearchGate, July 2011