‘It takes a community’: As health care providers struggle with burnout in a tightly regulated industry, cooperation is key to relief | MyWindsorNow.com

‘It takes a community’: As health care providers struggle with burnout in a tightly regulated industry, cooperation is key to relief

Trevor Reid
treid@greeleytribune.com

Doctor Benjamin George stands at his desk Thursday as he works at his office at North Colorado Medical Center in Greeley. While hospitals are taking measures to stop physician burnout, the efforts of doctors like George are proving to be just as effective.

Before UCHealth administrators changed the system, Dr. Christina Reimer remembers having to enter the many details of a patient's visit herself.

"I would sit behind a computer screen in an exam room with a patient," Reimer said. "Having been a patient on the other side of that computer screen, it doesn't feel necessarily like the provider's interacting with the patient, but more so with the computer."

Reimer's experience probably sounds familiar. Federal and insurance regulations require detailed medical records, and health care providers such as Reimer typically had to enter those details themselves. It can be menial work that takes health care providers away from direct contact with patients. Such regulatory work is a leading factor in physician burnout.

Though awareness of and efforts to prevent physician burnout have gone up, Reimer believes burnout has been escalating for the past five years. Dr. Jennifer Main, a medical director in care coordination at Banner Health, said the way burnout manifests itself can vary from provider to provider, but without intervention, the results are often the same: skilled, compassionate health care providers leaving the medical field altogether. With the growing threat of a national physician shortage, health care administrators are taking a serious look at the effects of burnout. A recent study by the Association of American Medical Colleges estimates a shortage of between 40,800 and 104,900 physicians by 2030 in the U.S.

“Focusing on everyone else can lead to self-deprivation and not paying attention to one’s own needs,” Main said.

— Dr. Jennifer Main, a medical director in care coordination at Banner Health,

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"Professionals hide it so well that you can't look across a hospital or a clinic and really see burnout," Main said.

Burnout leaves providers feeling like they have no mental or physical energy left at the end of the day, sometimes before the end of the day. Providers who experience burnout often feel like they've lost touch with why they do their medical practice. Though burnout for the most part occurs within the work environment, it can spread into providers' home lives as well. Main said it's a serious risk factor for depression and anxiety.

Physicians are in a particularly vulnerable career for burnout, according to Main. Attributes like altruism, a drive for excellence and curative competence can leave physicians hesitant to look for problems inward.

"Focusing on everyone else can lead to self-deprivation and not paying attention to one's own needs," Main said.

Fighting burnout

In the past five years, UCHealth administrators oversaw an effort to redistribute the work that was once done primarily by the physicians themselves to a team of providers and support staff. Now, as Reimer talks to patients for primary care, a medical assistant takes notes, as well as much of the burden of the computer work.

Electronic health records have obvious benefits, giving access to important patient details no matter where a provider is located. However, studies show electronic health records might have added up to three or four hours of work a day for physicians, according to Margo Karsten, CEO of Banner Health in northern Colorado. Giving physicians the option of taking their work home at night through electronic records has also added to a blurring of work-life boundaries. Steve Hess, UCHealth's chief information officer, said he leads teams to help physicians and other staff become familiar with the electronic systems as they're updated.

"We're giving them minutes, if not hours, back in their day to spend time with their patients, with the patients' families, and frankly create some work-life balance for the staff and the doctors themselves," Hess said.

Other efforts have focused on addressing the social isolation that typically goes hand-in-hand with burnout. Dr. Benjamin George at Banner Health helped start an informal group of health care providers to talk over interesting articles. At the most recent meeting, Karsten said, about 70 physicians showed up. Karsten also said she's worked to include physicians in decisions that directly affect them, giving providers a sense of autonomy back.

Reimer said initiatives like "Patients Before Paperwork" are pushing to reduce administrative burden. Advocates of the initiative demand that when new rules are proposed, the value to the patient be justified before more work is added to providers' workloads.

Patients can do their part fighting burnout by learning about the health care system and compassionately engaging with their providers. Many physicians have told Karsten about the benefits of a personal note from a patient. Main admitted to keeping a "rainy day" folder of personal notes from over the years.

"In the health care system we're in now, we need our patients to be activated patients, engaged patients, (to) have family members or friends with them to help make sense of health care," Main said. "It takes a community."