Rooting out physician burnout

By Wall Street Journal Custom Content with athenahealth | September 27, 2021


Dr. Emil Avanes, owner and director of Harmony Health MD in Glendale, California, is passionate about treating patients. As one of three physicians at his eight-year-old practice, he describes the rewards of his profession: “You get to work with people on their most difficult days, on their most difficult problems, and turn things around for the better. There’s huge potential for fulfillment.” Still, despite being “so happy with what we do,” Avanes admits he and his fellow doctors sometimes feel as if they are experiencing an “existential crisis.”

Clerical and time pressures

Even before the pandemic turned the world upside down, healthcare workers were feeling burned out. A 2020 survey of nearly 800 physicians (mostly in primary care), conducted by Watertown, Massachusetts-based athenahealth, found that burdensome administrative tasks and onerous regulatory compliance requirements have been major contributors to burnout.

“There is always this stress over, did we dot all our i’s and cross our t’s,” says Dr. Vik Mali, a pediatrician and owner of Mali & Mali Pediatrics in Sterling Heights, Michigan.

Dr. Jae Ahn, chief medical officer at Union Community Health Center in the Bronx, New York, similarly recounts the growing administrative expectations around patient visits. She notes that after the intake interview and medical history review, doctors must “create a plan of action for care, document everything that transpired, write all the prescriptions, write referrals, make any recommendations, talk to the care team and make sure all the appointments are done.” And compounding this load? “They want us to do all this in 15 minutes,” Ahn says.

Like their patients, Avanes and Mali prefer not to rush visits, but for primary care physicians, time is money. With a fee-for-service payment model still dominating U.S. healthcare, doctors are seeing more patients, and often for a shorter span of time, to meet their operational costs.

“One thing that leads to physician burnout is this notion that we’re not reaching our optimal fulfillment,” Avanes says. The idea takes hold, he explains, when doctors are “forced to take care of so many things outside of what the natural doctor-patient relationship requires.” Even during the all-too abbreviated patient visit, he points out, attention to care is chipped away by charting and all manner of hiccups using outdated technology to do so. “Heaven forbid, if you don’t type well. And dictation was supposed to be the panacea,” he says, “but that takes time, too.”

The way forward

Mali says that thanks to developments in healthcare technology, his practice is seeing the light at the end of the tunnel. He notes that he and the other on-staff providers spend from two to four hours every day on tasks outside of direct patient care. In order to tackle more efficiently “the layers of administrative expectations put on us” and still provide quality patient care, his practice partners with athenahealth. Mali & Mali Pediatrics employs digital tools and COVID-19 screening modules by athenahealth Marketplace technology partner Phreesia, which help expedite patient intake, simplify appointment documentation, and keep doctors off their screens as much as possible in the exam room.

Soon, his practice will be going live with athenahealth-provided, AI-enabled technology that will "help our physicians and nurse practitioners document their patient interactions without having to do so at night after their kids go to bed," Mali says.

A big upside to the technology, Mali points out, is that it gives back precious time to his staff. “Because it’s being connected with those around you that probably helps most with recovery from burnout.”

When the pandemic hit, with healthcare organizations having to make the rapid shift to virtual care, providers were suddenly grappling with adopting new technology and spending more time with patients educating them about the coronavirus. But what providers initially anticipated to be extra burdens became, with the right support, a two-fold benefit: more efficient care and more receptive patients.

In 2019, Union Community Health Center had a one-year plan to implement virtual care with a software company that interfaces with athenahealth. When the pandemic shut down in-person visits, “we implemented virtual care pretty much in two weeks,” Ahn says. Despite the complexity of virtual care, the challenge of remotely training providers on how to use the software and the loss of control staff was feeling as COVID-19 took a toll on workers, “we were able to take care of all our patients in a timely manner and in a new capacity,” she says. “athenahealth helped us because we were able to communicate with our patients digitally. We could do virtual visits and we could text our patients care instructions and follow-up care reminders. It allowed our care team to effectively deliver care and communicate to our patients during the pandemic.”

The HIPAA-compliant texting made available through athenahealth is an integral part of Avanes’ team-based approach at his practice. He cites a feature inside a patient’s electronic health record that allows him to text a member of his team to request information or assistance as a big factor in improving in-person visits. “What’s great is I can use our time during the office visit to listen and educate more, rather than check boxes.”

When doctors feel purposeful and supported — and can spend quality time with patients — there’s potential for universal benefit. “One of the reasons you see a large number of patients getting vaccinated is because these folks are talking to their physicians, and physicians are taking the time to give sound advice and communicate the importance of vaccines,” Avanes says. Unburdened healthcare providers means better healthcare outcomes for everyone.

— Dr. Emil Avanes, Owner and Director, Harmony Health MD

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Written in partnership with Wall Street Journal Custom Content

Wall Street Journal Custom Content is a unit of The Wall Street Journal advertising department. The Wall Street Journal news organization was not involved in the creation of this content.