In part one of our physician burnout series, we spoke with President Dr. Quinn Pauly and Executive Director Colleen Camenisch of the Nevada Physician Wellness Coalition to discuss the state of physician wellness and the resources they provide to support healthcare providers. We learned how widespread physician unwellness is, and the consequences it has for provider mental and physical health, patient outcomes, and the overall quality of care in our healthcare system. The reality is, burned out physicians are less productive, more likely to leave their position, and more likely to make mistakes, which increases risk, lowers care quality, and impacts practice finances. Fortunately, there are things practice managers can do to support physician wellness. We asked physician wellness advocates Dr. Pauly and Colleen Camenisch to outline what we, as healthcare practice managers and healthcare IT professionals can do to support our provider teams.
Q: What do you think the healthcare IT industry, physician leaders, and medical practice managers can do to help alleviate physician burnout and increase physician wellness?
Dr. Quinn Pauly: The healthcare system in the U.S. is broken in a lot of ways. I don’t think it’s focused enough on patient care and what we all need to do to improve patient care quality, satisfaction, and outcomes. Conceptually, I think the electronic health record is a good idea. Medicine tends to lag 10-15 years behind other industries when it comes to digitalization. Unfortunately, the utility of the electronic health record—the digital version of your patient’s chart—is often not easy to use on a daily basis and not particularly intuitive. It’s a lot of time spent clicking on a keyboard and a mouse when we could be having face-to-face time with our patients.
It’s also taxing because of the repetitive nature, you know, if you have X number of patients per hour, it’s not possible to give even halfway decent care and do all the charting at the same time. So, we tend to take the charts home with us and complete them during “pajama time.” We put the kids to bed and then we’re still sitting in our bed, typing away on our laptop to finish the notes for the day.
That work-life integration is just out the window. So, I would love to see the healthcare data problem solved to include more integration, more user-friendly versions of what we do and to not have all charting be the physician’s responsibility. Anything that doesn’t directly impact patient care could be done by others.
I’m on the board of the Health Information Exchange in Nevada that’s trying to tackle this problem to make the ease of data transferable between organizations greater so that if you end up in an ER somewhere else, you don’t have to start all over again with your health history. It’s a bigger kind of health industry issue.
When it comes to the individual practice manager, I think having a good relationship with the physicians is really important. Make the physicians feel like they’re involved in some of the administrative decisions related to patient care and work-life balance. Keep an open line of communication. The better you get to know your physicians, the more likely you’re going to be aware of behavior changes that may signify burnout or depression.
Colleen Camenisch: One thing we’ve seen work at a hospital system in Indiana was bringing the IT department together with the physicians to figure out the most common technology challenges physicians faced. One thing they found that madea huge difference for clinicians was that they didn’t have to type in their password at every computer. They had a badge that logged them in and out. Just that simple removal of that task that they might to 100 times a day made a huge impact for the physicians.
Don’t underestimate the power of bringing the two worlds [clinicians and IT] together. You know, sometimes we’re thinking about such a huge system, and it might be like a behemoth to change, but there might be some small things that make a big impact.
Another thing I would say is that you could be on the lookout for burnout by paying attention to trends charting errors. If charting errors increase, that might be one of the first places to have a conversation. Like Dr. Pauly said, really having those relationships with the team checking in and make sure someone’s doing okay goes a long way.
Dr. Quinn Pauly: Yes, we saw a similar success at one of the big hospitals in San Francisco. Their ER said, “Okay, we want the doctors at the table when we make these IT decisions because they’re the ones that are the end users” They also brought in staffing. In medicine, the margins for keeping your clinic doors open are pretty small right now. So, if you don’t have the right team, you will struggle. This hospital realized that if they hired two medical assistants per doctor, they would get more done, they would help handle the charting load, and patients and clinicians would be happier. Investing in hiring another person is a big decision, but often it helps alleviate burden and has a positive impact on clinic finances and patient outcomes.
Colleen Camenisch: Another thing that might seem really simple and obvious, is really thinking about integrating dedicated work time during working hours to chart, rather than expecting physicians to chart after hours.
Additionally, it is helpful to have someone in the institution that is a wellness champion. When someone is vulnerable and shares their story with burnout, it de-stigmatizes the issues and people come out and ask questions and share their experiences.
Dr. Quinn Pauly: Another basic thing is being aware of national and regional physician wellness resources. I think if practice managers were aware of what their local resources were and made those resources known to their clinicians and their families, that would be a, a big step in the right direction.
The reality is that there is a physician culture of overworking and sucking it up. We need to change the mentality that just because we are caregivers we cannot be sick ourselves. We think we are superhuman, but we are not. We are just human. Sooner or later, things take their toll.
Watch the full interview below
Quinn Pauly, MD
Dr. Quinn Pauly is the inaugural Chief Medical Officer at Switch, providing leadership and innovation for all of Switch’s healthcare endeavors. His professional goal is to advocate for the intelligent use of technology and data to make the US and Global health care systems maximally functional for all. Dr. Pauly is a board-certified Family Physician, a Fellow of the American Academy of Family Practice, President of the Nevada Physician Wellness Coalition, Health Information Exchange Nevada Board Director, and immediate past-Treasurer of the American College of Lifestyle Medicine. In addition to 30+ years in the continuous clinical practice of medicine, he is a recognized thought leader in Lifestyle Medicine, Physician Wellness/Physician Burnout, and Healthcare Industry Wellness Programming including Intensive Cardiac Rehabilitation. Dr. Pauly’s hometown is Reno, Nevada, where he attended Wooster High School and the University Of Nevada School Of Medicine. He received his undergraduate degree from Pomona College in Claremont, California. Dr. Pauly performed his UC San Francisco Family Medicine Residency at Natividad Medical Center in Salinas, California. Quinn enjoys watching his children mature into well-rounded adults, and in his free time he enjoys hiking, mountain biking, and fly fishing.
Colleen Camenisch, MBA
Colleen Camenisch is the executive director for the Nevada Physician Wellness Coalition. Camenisch has a master’s degree in business and many years of experience in graduate medical education working with medical students, including the University of Nevada Reno Medical School and UMass Medical School in Massachusetts. Camenisch is also a faculty member at Brown University, where she teaches Mindfulness Based Stress Reduction and meditation courses.
About the Nevada Physician Wellness Coalition
The Nevada Physician Wellness Coalition (NPWC) was formed to provide support and resources to physicians and their families. Our mission is to address the devastation and negative community impact of physician burnout and suicide through de-stigmatizing physician mental health issues and creating opportunities for physicians to feel safe to come together and share their experiences. NPWC offers a resource line and safe and accessible community building and educational programming to proactively address physician wellness from pre-burnout to burnout and depression. Visit nevadaphysicianwellnesscoalition.com to learn more and subscribe for updates on programming
NPWC Resources
Physician and Family Resource Line: 775-404-3307
Operated by licensed psychologists with expertise in physician stress, Monday-Friday 9-5pm
Other Resources:
· Nevada Suicide Hotline: 1-800-992-5757
· Crisis Call Number: 1-800-273-8255
· American Medical Association Conference on Physician Health
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