geoffrey modest medical blogs

  A  colleague of mine sent me this email in response to my blog  http://gmodestmedblogs.blogspot.com/2023/04/healthcare-worker-burnout-whither.html .  as always, i asked them permission to pass comments on.   My colleague wrote: "It's ok to send around but I think better to say 'note from a colleague', since it mentions the corporation and I'm not yet ready to be 'asked' to retire.  I don't usually feel the need for this but such is the times.   The leadership can be pretty autocratic, coming around to update us and ask for our thoughts but they've come down hard at times on those who voice criticism in these forums."  Thanks for this review on burnout.    Here's the short version of my response/rant :) You've probably heard of "If I Betray These Words" by Wendy Dean, about moral injury in medicine?  I heard her speak on WBUR and also have read and heard Eric Rheinhart (NYT op-ed and a youtube interview) on the subject.  ...

      A recent article assessed work overload and healthcare worker burnout (see health worker burnout JGIM2023 DOI: 10.1007/s11606-023-08153-z )   Details : -- cross-sectional national survey of 206 large healthcare organizations from the AMA Coping with Covid Study survey, from 30 states with at least 100 physicians, between April and December 2020 -- healthcare worker work overload (by impact of Covid), burnout, and likelihood of leaving one's practice in the next 2 years (a good predictor of actual turnover), by questionnaire -- 43,026 respondents were invited, mean response rate 44% -- information was available for demographics and years in practice (categorized as   1-5, 6-10, 11-15, 16 -20, and >20) -- 35% physicians (15,142), 26% nurses (11,040), 13% other clinical staff (5730 pharmacists, nursing assistants, respiratory therapists, physical therapists, occupational therapists, speech therapists, medical assistants, and social worker...

Another study came out detailing the large excess physician time required when using electronic health records (EHR) for outpatient encounters (see electronic med record timesink AIM2020  in dropbox, or doi:10.7326/M18-3684) Details: --they reviewed 154,719 physicians in 417 health systems during 2018 in adult, nonsurgical, ambulatory practices in the US who used the Cerner Millennium EHR (an associated 98,211,891 patient encounters), focusing on 13 clinical EHR functions     -- practice sites: 34% integrated delivery networks, 30% regional hospitals, 22% physician groups, and 11% academic medical centers     -- they assessed time spent on chart review, documentation, messaging, writing orders, searching for patients/appointment scheduling, med reconciliation, allergies, problems/diagnoses, responding to alerts, health maintenance/preventive care, end-of-visit functions/patient education, and reviewing and updating history [unfortu...

electronic health record and physician burnout G      Geoff A. Modest, M.D. Wed 12/18/2019 7:25 AM Geoff A. Modest, M.D.  A study from the Mayo Clinics found a strong association between perceived electronic health record usability by  physicians  and professional burnout (see  electronic med record MD burnout mayo2019  in   dropbox , or doi.org/10.1016/j.mayocp.2019.09.024 ). Details: -- cross-sectional survey of US physicians from all specialty disciplines from October 2017 through March 2018, using the American Medical Association Physician Masterfile -- 30,456 physicians were invited to do a survey, 5197 (17%) completed it.      -- 1250 (25%) of them were randomly chosen to receive a sub-survey evaluating electronic health record (EHR) usability; (70%) completed it, leaving 870 evaluable results    ...