You’re burnt out and work hard day-in and day-out.
Getting caught up in the daily tedium of a schedule can really affect work performance. But beware — it can also cause a rise in adverse events and increase risk. Consider the following scenario:
After taking your kids to school, you get to your practice. The business manager advises you that the insurance company wants to perform an audit of multiple records that were submitted improperly and the superbills don’t match the coding.
In the meantime, you have a full schedule with appointments every 30 minutes. The first patient asks so many questions that it has now run into the next patient’s appointment, wherein the patient complains to the front desk supervisor.
You finally get to the next patient, and he or she is more focused on how long they have been waiting than focusing on their chief complaint —pushing the schedule back further. You walk out of the room to consult with one of your RNs, but hear a staff person at the front desk yell for the doctor.
That’s right — you’re up. And the patient in the waiting room isn’t breathing.
Is this you? Many things can go wrong in this specific scenario, from the patient in the waiting room becoming the victim, to some out-of-the-ordinary issue affecting one of the other patients in the middle of care.
In a study performed to analyze the effect of physician burnout on provider-to-patient communication in an urban community-based setting, it is noted that the provider typically is “burnt out” within approximately 15 months and that this burnout directly affects the rapport-building ability of that provider-to-patient relationship. This can affect patient retention and trust— two key things that are important to mitigate risks in any patient-centered environment whether an active claim exists or not (Ratanawongsa et al., 2008).
Simply ask yourself — are you more receptive when you are tired, and do you perform your best when your eyelids can hardly stay open?
Potential Adverse Events
Of course, when risks are exposed, the likelihood of an adverse event increases. Physician burnout relates to many mistakes that occur in an office practice, under the operating room lights, and even when sending medical information. A few examples of an adverse event that could result from physician burnout include:
- Improper documentation (copy and pasting errors, misdiagnosis, forgetfulness)
- Surgical mishaps (improper technique, poor attention to detail during all stages of a procedure, wrong surgery, or wrong site surgery)
- Medication errors (prescribing wrong medications, prescribing improper amount of medication, contraindications or allergies unnoticed)
- HIPAA breaches (leaving a laptop unattended, leaving the EHR logged in away from a computer, talking about patient care near other patients)
- Quality of care complaints (provider mismanaging care or not performing specifically in tune with standards of care)
How to Prevent Physician Burnout
What can you do to combat physician burnout, maintain a patient’s trust, and improve the patient experience by providing quality care?
- Hire the right staff for the right job.
- Maintain your scheduled patients per day at a number that is reasonable and spread out.
- Encourage transparency with staff.
- Maintain a good rapport with patients.
- Train your office manager and maintain communication with him or her.
- Conduct staff training and meetings.
- Prioritize tasks, or ask colleagues for help.
- Take care of yourself.
References:
Craver, J. (2015). Physician burn-out rate on the rise. Benefits Selling. Breaking News.
Ratanawongsa, Neda, MD, MPH; Roter, D., Dr. MPH; Beach, Mary Catherine, MD, MPH; Laird, S. L., MPH; Larson, S. M., MS; Carson, K. A., ScM; and Cooper, Lisa A., MD, MPH (2008). Physician burnout and patient-physician communication during primary care encounters. Journal of General Internal Medicine, 23(10), 1581-8.
Steven Blackburn is a Senior Risk Management and Patient Safety Specialist for the Cooperative of American Physicians. Questions or comments related to this article should be directed to sblackburn@CAPphysicians.com.