Category Archives: Practice Enhancement

The Physician’s Pursuit of Work-Life Balance 

January 14, 2021

Current burnout rates and physician dissatisfaction levels are nearing an all-time high; with the ever-increasing demands of a pandemic-torn healthcare system, a work-life balance is not easy to achieve within this profession. Per recent research, physicians work an average of 51.4 hours a week while nearly a quarter works between 61 and 80 hours a week, making it increasingly difficult for them to balance their personal needs with their work schedule. At the same time, 92% of surveyed physicians aged 35 or younger reported work-life balance to be an important aspect while female physicians in particular report work-life balance as a significant concern.

The “life” component can encompass wellness needs, social interactions, family life, and other pursuits as well as daily living activities. However, due to an increase in mobile technology and services that keep physicians connected to their practice, work-related tasks have begun to extend more into aspects of their personal lives and moments of free time. As the line between work and life continues to blur, healthcare professionals face a growing risk of increased burnout and other adverse physical and psychological outcomes.

The Pursuit of Work-Life Balance 

According to Dr. Arun Saini, assistant professor in the Division of Critical Care Medicine at the University of Tennessee, dissatisfaction, depression, and burnout are some of the most common reasons physicians seek a better work-life balance.

“Most millennial physicians are paying more importance to work-life balance after seeing the firsthand effect of burnout in their colleagues and among their family members. There is also a shift in the family dynamics of [the] millennial, as most families have both parents working and limited support from immediate family members. This has put additional pressure on their abilities to manage work-life balance,” Dr. Saini told Medical News Today.

Without adequate rest and recuperation from the demands of the workplace clinicians can experience burnout, which also negatively affects their clinical performance and the health outcomes of their patients.

A Counter Approach

However, other experts disagree by arguing that the pursuit of a work-life balance can actually worsen a physician’s quality of life. According to Dr. Andreas Schwingschackl, assistant pediatrics professor at the University of California, Los Angeles, the separation of work and life indicates conflict – that work is inherently “bad” and life is “good.” Instead of seeking a clear-cut distinction between a career and personal life, he recommends a different approach.

“Once I was able to integrate rather than separate all my daily activities [and] harmonize rather than divide my time, not only between work and life but also between clinical care and research, the pursuit of balance shifted from work-life to life-nature-universe. The result was an overwhelming daily feeling of ‘balance,’” he told Medical News Today.

Tips for Achieving Work-Life Balance

Several factors can be optimized to help physicians achieve a sense of balance between their work and personal lives.

Define Purpose

One important element needed to support balance is having a sense of purpose. Over time, physicians may lose passion for or satisfaction with their line of work making it especially important for them to incorporate more tasks that align with their initial motivation for pursuing medicine. This can include scheduling procedures they enjoy, working on patient cases they find interesting, and dedicating time to explore their passions in the field. “Finding meaning in your work should also take into account family needs and aligning your own needs with those of your organization,” experts highlight.

Manage Time With Intention 

Balancing work and life requires effective time management, which includes setting both long- and short-term goals, planning and organizing, and using time productively. Some strategies to manage time more efficiently can include preparing electronic health record templates, making checklists, outsourcing housework, and meal-prepping for the week ahead. Minimizing time wasted with effective scheduling and time management can allow healthcare professionals to maximize their free time to spend on personal priorities, family activities, and social interactions.

Prioritize What Matters

Another important technique for improving work-life balance is the identification of what is most important among your responsibilities and managing your time to prioritize it. For instance, if family life is your priority, you can adjust your schedule so that you maximize days with your family members and work a reduced number of hours. Evidence supports working fewer hours which is associated with a reduced risk of burnout; data from a Medscape report reveals that only 36% of those working between 31 and 40 hours a week reported burnout symptoms compared with 57% of those working over 71 hours. 

Set Boundaries

Due to the shift to telemedicine and increase in the use of mobile technologies, the clinic is no longer the only place one can reach physicians. As a result, the line between work and life is becoming even more blurred leading to the development of an “integrated lifestyle” in which both components are expected to exist simultaneously. However, this is rarely conducive to the separation of work matters from physicians’ personal lives making boundary setting especially pertinent. For example, physicians can designate working hours on their personal devices during which they can receive calls, emails, and other notifications; outside of these set times, they can mute work-related notifications or turn off their devices entirely.

As there is currently no set standard for an appropriate work-life balance equation, what constitutes this at times elusive concept depends entirely on personal needs, preferences, and priorities. Although, there are several methods for achieving a more harmonious balance between professional and personal lives.

With the COVID-19 pandemic continuing to take a huge toll on healthcare professionals, it is especially important for physicians to carve out time for rest and personal needs so as to avoid the possibility of burnout – a condition that not only has detrimental effects on their wellbeing, but also on that of their patients. Clinicians who feel overwhelmed can reach out to the national Physician Support Line which provides free and confidential support services.

Humanizing Virtual Care for Patient Satisfaction

November 20, 2020

Although only 8% of American patients had previously attended a telehealth visit before the pandemic, up to 83% expect to continue telehealth visits even after the pandemic subsides. In 2019, only 28% of physicians reported using telehealth technologies. Now, virtual consultations and online visits are beginning to replace the traditional model of in-office appointments.

Growing Demand, Declining Patient Satisfaction

While some healthcare professionals have expressed concern about the impact of telehealth on patient-provider relationships, arguing that digital care will be hinderance to personal connections, the past few months have revealed that virtual visits can effectively support and even deepen relations with patients. However, the effective delivery of online care requires strategic efforts that go beyond traditional patient-provider interactions.

Although patient demand and desire for digital visits continues to rise, overall patient satisfaction with such services is reportedly decreasing. “As patients become more engaged, informed, and involved with their health care decisions, and demand better access to care, virtual health solutions will play an important role in meeting expectations,” a recent report by Deloitte highlights. Virtual healthcare needs to continue efforts aimed at humanizing online care by extending the patient-centered care delivery model.

Humanizing Virtual Care

There are several ways to connect with patients virtually, all of which work to strengthen the patient-provider relationship. Some, such as automated messaging services, can even help lessen clinician workload by handling mundane administrative tasks while continuing to foster the patient-provider connection. Primarily, healthcare professionals need to prioritize using technological solutions to their advantage and as communication tools to develop a consistent relationship with patients.

Life-Centric Care:

The ubiquity of technology in our lives, ranging from smartphones to smart watches, allows for continuous tracking, monitoring, and communication. Focusing on embedding virtual healthcare into a patient’s digital life, providers can leverage the technology and tools they use on a daily basis to foster patient engagement. This can include utilizing data and content sharing applications to create personalized, high-quality interactions, sending reminders, and other communications that emphasize a life-centric care model.

Two-Way Texting:

As a decreasing proportion of the population now accepts incoming phone calls and many do not even check their voicemail, text messaging has become the preferred method of communication; up to 47% of patients express wanting to be able to text back and forth with their healthcare provider. With quick, efficient communications, two-way texting is an important step toward humanizing the virtual relationship.

Educational Communications:

Regularly sharing educational content, such as newsletters, blogs, and emails, can reinforce the feeling that providers care about their patients’ health. During the pandemic in particular, it is important to consistently communicate with patients by sending targeted educational information – to at-risk individuals especially – that provide individualized recommendations for staying healthy.

Automated Post-Visit Calls or Emails:

The majority of patients fail to remember all of the details of recommendations and treatment instructions provided during visits. Here, the use of automated messaging – including phone calls, voicemails, texts, and emails – can help remind patients of post-appointment care instructions. Such reminders will also improve treatment adherence while reinforcing the message that providers care about patients and their health.

Appointment and Billing Reminders:

Another facet of care can easily be automated using messaging systems; sending patients automated reminders of upcoming appointments and overdue bills can be used to increase touch points, triggering name recognition as well as remembrance. Patients will likely recognize and appreciate these efforts to simplify their lives, benefiting the overall relationship they have with their medical practice as convenience is increasingly valued.

The modern medical practice can leverage this ongoing shift toward digital care, taking advantage of the many virtual opportunities for connection and communication with their patients. While in-person interactions may be limited at this time, patient-provider relationships need not  fall to the wayside. With a healthcare industry primed for expanding adoption of telehealth, virtual health will increasingly become a part of consumers’ daily routines. If clinicians commit to telemedicine at a personal and organizational level, they can take advantage of the growing opportunities to deliver connected, coordinated, and comprehensive care.

Open Notes: Patient Transparency and the New Federal Mandate

October 28, 2020

Alongside a surge in telemedicine adoption and increasing reliance on technology, the growing shift to digital healthcare delivery has prompted a cultural shift in medicine forcing many clinicians to abandon the traditional model in favor of a more modern approach. An elemental component of the modern medical care model is patient transparency, which has been at the forefront of discussions in recent weeks due to the forthcoming implementation of a new federal mandate.

To support universal patient transparency, beginning November 2, 2020 all patients in the United States will have immediate access to clinical notes and thus, will be able to read and review clinician’s writings, test results, and other health reports. Per the 21st Century Cures Act systems need to “support patients’ access to their EHI in a form convenient for patients, such as making a patient’s EHI more electronically accessible through the adoption of standards and certification criteria and the implementation of information blocking policies that support patient electronic access to their health information at no cost.”

Open Notes Policy 

Referred to commonly as “open notes”, the new federal mandate requires the release of all inpatient and outpatient notes for immediate patient access, including test results with potentially sensitive information. The information now made available to patients immediately includes consultation notes, discharge summaries, medical history, physical examination findings, imaging narratives, laboratory and pathology report narratives, and procedure and progress notes. Unsurprisingly, the plan has been widely contested by healthcare professionals who fear it will result in increased workloads and adverse patients reactions. However, there has been a growing adoption of the new protocols with time as evidenced by several institutions which have already implemented the policy.

Those supporting the new law believe it has the potential to strengthen patient-provider communication and relationships. Certain healthcare institutions are ahead of the curve; UC Davis Health voluntarily implemented open notes a year ago although only two dozen of 1,000 staff physicians opted into the program. Nonetheless, those that did reported positive results and support for the initiative. Similarly, at the University of Colorado Cancer Center, open access to oncology notes has been granted to patients for the past 5 years with no reported issues and highly appreciated by patients.

Sensitive Health Information 

Sensitive information may present more of an issue in certain specialties, such as oncology, psychiatry, genetics, and adolescent medicine. For instance, when reading pathology or imaging notes, patients may learn they have been diagnosed with cancer without a physician’s explanation or contextualization. In oncology specifically, patients may struggle to understand their prognosis and treatment plan leaving them stressed, frightened, and/or confused. In certain cases, the importance of physician contact and empathy may be much needed and more valuable than previously thought.

Medical professionals highlight the importance of clear, open, and honest communication with their patients to better accommodate the forthcoming open notes protocols. “When I order imaging or send pathology specimens, I have already discussed with the patient the possibilities, including cancer, and what we will do next. Patients deeply appreciate these discussions, before they see the results,” Dr. Robert Breeze, vice-chair of neurosurgery at UCHealth in Anschutz, Colorado told Medscape in an interview.

As clinicians tend to write notes in medical lexicon, they may now need to write things out in lay terms for the benefit of their patients which may potentially generate more work. Although the new mandate does not require a change in writing style, many clinicians may find they will need to alter their notes to make them more readable for patients, potentially making them less useful for utilization review, billing, and other internal purposes.

Clinicians in favor believe that the open notes policy will help serve overworked physicians by empowering their patients, allowing them to better understand their treatment plan and medication which can ultimately minimize the physician’s workload. Although the federal mandate may seem daunting, the benefits may outweigh the risks if notes are compiled in a patient-focused manner in line with a patient-centered care model. Access to clinical notes, results, and other important health information may promote patient engagement and treatment adherence, as well as deepen the patient-provider relationship.