Doctor Overload
Experts define burnout as a syndrome marked by emotional exhaustion, cynicism and decreased effectiveness. Many burned out doctors cut back their hours to cope, and a disturbing number commit suicide.
A landmark 2015 Mayo Clinic study found that more than 7 percent of nearly 7,000 doctors had considered suicide within the prior 12 months, compared with 4 percent of other workers. About 400 a year go through with it.
Driving the burnout symptoms is the burden of data entry on clumsy electronic medical records systems that doctors must use to prove the quality of their care, said Dr. Christine Sinsky, vice president of professional satisfaction at the American Medical Association.
Sinsky recently conducted an experiment in her own internal medicine practice in Dubuque, Iowa. She asked a staff member how many mouse clicks it takes to order and record a single patient's flu shot in their electronic medical record. The answer: 32.
She has visited some practices where a doctor had to record flu shots for more than 1,000 patients because only the doctor was allowed to enter the order.
Such mandates reflect an overly strict interpretation of federal health reforms designed to encourage doctors to use electronic medical records, such as the 2009 Health Information Technology for Economic and Clinical Health Act that required doctors to demonstrate "meaningful use" of the systems.
"We have to recognize the exacting toll that the first generation of electronic health records have had on physicians," Sinsky said. "I would identify it as one of the most important drivers of physician burnout."
Pre-approval requirements from health insurers for many services and quality metrics built into Obamacare have added to doctors' administrative duties.
"We've got this measurement mania. We've got to back off of that," said Dr. Paul Harkaway, chief accountable care officer for Michigan's St. Joseph Mercy Health System, a part of Trinity Health, a national not-for-profit Catholic health-care system.