Better physician communications decrease burnout, promotes better outcomes

I don’t know any physician who hasn’t experienced some form of burnout — even before the pandemic. It certainly has happened to me, about a year after I completed my training and started my career as a pediatric endocrinologist.

There weren’t enough hours in the work day to complete all the documentation, so I started bringing it home. You see the kids, have dinner, go to the gym, and then get back to work. And then you’re on call for a day or a week, and more work piles up. Each day, you get a little less sleep and a little less sleep and the next thing you know, it snowballs until you start to examine your life choices.

I feel very fortunate to have gotten through that rough patch and reached a healthy balance between my work life and my personal life. The secure communications platform my hospital purchased certainly has helped, reducing the hassle of trying to communicate with physicians, other care providers, staff, and patients. Because communications are more efficient, I simply can get more work done in the same amount of time.

Barriers to communication contribute to burnout

According to a 2017 report, more than half of all physicians reported spending 10-plus hours a week on administrative duties. The same report from 2022 shows that amount of time had increased by half, to more than 15 hours each week for every physician. That’s 15 hours a week we’re not seeing patients and making diagnoses.

The same survey queried physicians about their main job frustrations, and bureaucratic chores such as charting and paperwork top the list. In fact, 60% of physicians chose bureaucracy related to paperwork as the main frustration, far outpacing other leading responses such as lack of respect (39%), too many hours (34%), and too little pay (28%). Together, these factors certainly contribute to burnout, with 54% of doctors saying that burnout has a strong impact on their lives and another 22% reporting a moderate impact.

The burnout statistic for physicians was double that of the general population — before the pandemic hit the world, with healthcare bearing the full effects. The president of the National Academy of Medicine said during a webinar that up to 75% of clinicians report symptoms of depression, exhaustion, PTSD and sleep disorders. The president estimated 20% of healthcare workers left the profession in the past two years, and 80% of those who remain indicate that staffing shortages affect their ability to care for patients adequately and safely. In dollar terms, burnout costs healthcare $4.6 billion a year, according to research.

Speaking of physician shortages, projections from the Association of American Medical Colleges indicate a shortage of between 38,000 and 124,000 physicians by 2034, including up to 48,000 primary care physicians, 30,000 surgical specialists, and 13,400 medical specialists. These shortages hurt efforts to remove barriers to care, especially in historically underserved geographies and medical specialties.

So what’s the answer to physician burnout caused by too much work and too many administrative duties? It’s to work smarter and not harder, an area where communications technology has been helping me and my hospital.

Finding a better way to communicate

The shift to the electronic medical record was an overall positive for patients to reduce the incidence of preventable errors through missing paperwork, illegible handwriting, and failure to notice potential drug/drug interactions, among other reasons. But it greatly increased the amount of work that physicians and support staff had to perform.

Phone messages now compete with portal messages, prior authorization documentation, electronic chart reviews, and more. Oftentimes, I just want to talk to a physician, nurse, or patient without jumping through hoops or navigating communication layers. What I did before, of course, was use the most-direct method, which often wasn’t secure. We’ve all used iMessage, WhatsApp, and our personal cellphones to not only talk about patients but to exchange data.

The security of health communications is the reason my hospital invested in a new communications platform that integrates with our EHR. But we’ve found it does so much more. About 80% of my practice time is spent as a consultant. Another physician refers a patient to me; I examine the patient and communicate next steps back to the physician. Through an app, we can use our personal devices to find each other quickly and easily through chat, exchange information or have a discussion, and get back to our day. No more scrolling through my contact list or struggling to find the on-call physician or technician for a particular specialty.

It's made inpatient care and working from home more efficient, too. For both, I often need to communicate plans, labs, medicines to residents, nurses, and primary care teams. Before, it was trial and error to track someone down on the floor, but now it’s easy.

Communicating with patients is also a snap. Although many, many physicians have my cell, that’s a number I definitely don’t want to give out to patients. If I’m in my office, I can call patients from my office line, but for long-distance calls I must use the hospital operator to make the call and connect me to the patient. With the communications app, my phone number is masked and the auto-dialer says “healthcare” and the city name, so I can talk to patients from wherever I am.

Two-plus years in, we’re still finding new communications uses. For example, some of our nursing units use the tool to communicate with ancillary services such as respiratory therapists.

Finding a solution that cuts through the clutter and facilitates fast and easy communications certainly makes my life easier. And it makes patients’ lives better. Faster and more effective communications means care is delivered quicker, treatment plans come together more easily, and patients can go home sooner.

What’s not to like?

Joshua Tarkoff, MD, MBA, is medical director of IT at Nicklaus Children’s Health System