Burdens to Physicians



  • Myself and a couple other physicians came up with these "top 10" burdens to physicians in the current healthcare system (in no particular order):

    1. Unintuitive EMR
    2. Documentation burden (for legal/insurance purposes; spend more time in front of a computer than a patient)
    3. Administrative burden (pressure from administration to see more patients in less time)
    4. Prior authorization (insurance companies questioning medical decisions)
    5. Patient’s with no interest in self-care who want a quick fix ("entitled" patients; though it is not all the system's fault, the current reactive healthcare model does not endorse self-care)
    6. Patients with overwhelming medical conditions due to avoiding healthcare because of high co-pays, lack of coverage, or lack of interest in self care (By the time they see a provider, they take more time and resources to recover)
    7. Fighting insurance companies for appropriate reimbursement
    8. Time constraints (superfluous responsibilities/duties irrelevant from a clinical standpoint... also patient demand outweighs physician supply)
    9. Established reactionary culture within the current system. Not conducive to health/wellness/prevention due to time/administration/insurance burdens
    10. Stress/Burnout/Fatigue/Depression from all of the above


  • Very good list! One thought regarding 1 and 2. The EMR hasn’t just changed how we document, or the time it takes to document, or the efficiency of documentation. It has become a third person in the room. In fact, it may have become the new center of the interaction between doc/patient and has changed the entire interaction- not the least is which making the human part of the interaction, the fun, special part of our job, much less satisfying.



  • Did you all get to see this excellent article by Dr. Atul Gawande?

    https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers.

    I want to pick it apart and have a discussion about it. There are uncovered gems waiting to be unearthed here. The ideas abound that we can act and build on....



  • @MeganJanas One ongoing issue is that these "solutions" are developed and trained in isolation from the very environments they are intended. Development is a collection of meetings in conference rooms without any direct observation where the person and the tool will interact. The same mistake is made in training.

    If the intention is for this to be a solution, development and training have to be conducted in the actual workspace.