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Can access to specialist physicians mitigate burnout for primary care?

Posted: Tuesday, June 25, 2019

By Dr. Ed Cladera, AristaMD Medical Director

Can access to specialist physicians mitigate burnout for primary care?A dangerous epidemic is sweeping our nation and greatly affecting the very individuals we count on to protect us. The epidemic known as provider burnout affects more than 40% of our physicians. In this article, we will explore how access to specialist physicians via telehealth solutions like eConsults can positively impact the nationwide problem.

What is Provider Burnout?

Provider burnout is categorized as a long-term stress reaction marked by physical and emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment. Frightening symptoms of burnout include depression and suicide, increases in medical errors and patient mortality, increased rates of physician substance abuse as well as professional and personal relationship dysfunction.

Many physicians are leaving medicine mid-career due to the effects of burnout, contributing to the already staggering projected physician shortage of 100,000 by 2030. For those that choose to hold onto their medical profession, the symptoms can begin to affect patients. Physician burnout can lead to the development of negative or cynical attitudes towards patients and their health concerns, increased distraction that causes medical errors, and overall decreased provider professionalism leading to reduced patient satisfaction.

A 2014 study involving intensive care doctors showed that emotional exhaustion among physicians, one of the main symptoms of provider burnout, predicted a higher mortality rate among the patients for whom they cared. The public health crisis is robbing us of our dedicated healthcare professionals and physicians at the front line of care.

Who experiences Provider Burnout?

Emergency medicine, family medicine, OB/GYN and general internal medicine experience the highest rates of provider burnout at 47%, 46%, 60% and 46%, respectively. Primary causes of burnout include excess bureaucratic tasks such as charting and paperwork, inefficient work environments, loss of autonomy along with loss of flexibility and control in one’s career and day-to-day work experiences. Finally, affected medical professionals also report a loss of meaning in one’s work exemplified by the feeling of being unable to provide impactful patient care.

Providers impacted by the effects of burnout have been reportedly feeling as if the dedication and work they put into their profession day to day has no significant impact on their patients. Dr. Denise Gomez, Internal Medicine physician and Medical Director at San Diego FQHC North County Health Services (NCHS), states “Non-clinical tasks that aren’t directly involved in the direct care of the patient are frustrating for providers. The frustration leads to a sense that they are not fulfilling their professional mission and fuels the fire for burnout.”  In addition, providers are citing a loss of control in the work environment along with feelings of an unmanageable workload as a contributing factor in cases of burnout.

There is no cure for provider burnout, but leading healthcare organizations have put a priority on the stewardship of available resources to help alleviate the symptoms.

Amidst growing advancements in the telehealth arena, digital health solutions are becoming part of the conversation to alleviate physician pressures.

Telehealth solutions that allow providers to more effectively treat patients, save invaluable time and brings more control to an otherwise stressful environment. Asynchronous (store-and-forward) virtual care solutions offer an added element of flexibility to treat patients at the time and location that is most convenient for both the patient and the physician.

One such asynchronous telehealth solution is electronic specialist physician consultations, or eConsults.  eConsults are secure, HIPAA compliant online consultations between providers; most often between a PCP and a specialist physician. By allowing PCPs to deliver documented specialty care insight to patients in a timely manner, eConsults have proven to deliver many benefits for providers.  eConsults have also been shown to provide relief from specific factors contributing to provider burnout.

eConsults combat PCP burnout in the following ways:
  1. eConsults allow physicians to feel they are maximizing their often-limited time with patients

The rapid turnaround time in receiving the specialist physician guidance that eConsults offer, allows PCPs to feel confident that the short time they have with their patients can be used to deliver the best possible patient outcome.

“Quality time with patients increases PCP satisfaction. Immediate specialty recommendations allow the physician to be more efficient, allowing for more time with patients and improved overall satisfaction.” Dr. Denise Gomez.

Director of Clinical Informatics and Pediatrician at Vista Community Clinic (VCC), Dr. Sue Park adds: “When I know that I have the eConsult platform in my toolbox, it’s easy to add this to the discussion with patients about their care. I can quickly get advice back from the specialist, schedule a follow-up appointment, and have a firm plan to implement instead of using the limited time I have with patients to monitor the progress and answer questions as to why their referral hadn’t gone through. Instead of spending time researching conditions and hoping to get the most up-to-date information, I can consult with a specialist and feel confident they have been vetted by trusted eConsult specialists.”

  1. eConsults offer physicians more control over patient outcomes

By having access to invaluable specialist physician insight, PCPs can feel confident about delivering the most comprehensive and highest quality care, helping to improve overall patient satisfaction.

Dr. Gomez finds eConsults to be a learning experience for providers. She states “eConsults provide a special learning experience for primary care physicians. Specialty input on the care of a patient enhances provider knowledge that may be utilized for future patients with similar medical issues. Providers then feel more comfortable and confident in the care of more complex patients leading to a reduction in provider burnout.”

Dr. Park has found “The more eConsults you do, the better you become as a clinician–like getting CME every day.  I have learned so much from detailed eConsult responses and this has made me a better physician. I have the confidence of specialty advice behind what I do and the patients appreciate this.”

  1. eConsults can restore PCP confidence in delivering the most meaningful care to patients

In closing gaps of care within the specialty referral process, PCPs can rest assured that they have more oversight of the care process. This ensures that a greater number of patients are able to access the care they need and reduces the number of patients lost to lack of appointment follow through. In addition, improving patient satisfaction through timely and effective care, in turn, increases provider satisfaction.

Dr. Gomez says, “Patient satisfaction and provider satisfaction are coupled. When patients feel they have received quality treatment, mission-driven providers feel more satisfaction in their work.”

eConsults allow for providers to strengthen the provider-patient relationship. This relationship strengthens, especially with the self-pay patients, as eConsults provide physicians with the satisfaction of delivering quality care to every patient in need.”

Learn more about how eConsult platforms are improving provider and patient satisfaction rates.

Burnout of our frontline providers has reached a point of crisis. As the adoption of telehealth continues to gain momentum, it’s crucial that healthcare providers learn to leverage technology that will not only reduce burnout but also simplify things for PCPs. eConsults offer several specific benefits to combat the symptoms of burnout. Learn more and hear what PCPs have to say about leveraging eConsults.

 

HEAR WHAT PCPS HAVE TO SAY

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