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Physician Burnout is Our Problem, too
10 Steps You Can Take to Encourage Your Physicians
The topic of physician burnout is becoming well known throughout the medical community. Studies show that demands from insurance companies, pharmacy benefit managers (PBMs), and, in particular, poorly-designed electronic medical records systems deplete our doctor’s time and brain power on tasks considered cumbersome and redundant. It’s no wonder that we see increasing numbers of physicians burning out. Physician fatigue can lead to medical errors, decreased quality of care, and the worst scenario – skilled physicians getting out of the business altogether.
Friends… this is a lose-lose for all of us.
Most physicians report the main sources of burnout and fatigue really aren’t from the patients directly, but rather from cumbersome processes and documentation requirements. There are numerous reports of computer fatigue. Time allotted for patients is often spent in hour-long phone calls with insurance companies justifying medical necessity for a test or scan, or staring at the computer inputting patient information. Most sources of frustration are beyond our control as patients, but we can still do our part to encourage our doctors and others on our care team.
Here are 10 things we can do to encourage our doctors and their staff, and to let them know we appreciate all they do.
1. Choose to believe we are on the same team
The first step we should make once we decide upon a physician is choosing to believe that we’re all on the same team. Be intentional in the belief that your physician is FOR you and wants you to win. The internet is full of patient groups where complaints about the doctors run amuck. Resist the temptation to join in this dialog. I honestly don’t understand patient comments like, “well, I just despise going to my doctor, she never listens to me about anything,” and other pop-up comments like this. Honestly, it says more to me about the patient than it does the physician. Why on earth would we have a doctor on our team when we don’t like or trust him and say mean things about him? Believing that our docs are on the same team as we are is one way to show appreciation for all they do and the battles they fight for us behind the scenes, like insurance approvals, procedure authorizations, etc. I’m sure there are some bad physicians out there who really don’t care about us patients like we want them to, but I’ve never met them. Ever. When our default thoughts are ones of mis-trust and dread for doctor appointments, then we would benefit from an honest assessment about being a patient in that practice. If there are concerns, talk to your doctor openly and honestly. Embracing this initial mindset that our doctors are on the team with us is a very important first step towards building a healthy relationship, which eliminates stress for everyone.
2. Build a relationship
A relationship built on respect and trust is mutually beneficial in any scenario. This takes time and a willingness to look out for the other person. When friends or colleagues interact with us from this angle, we naturally are more relaxed and less stressed than when we are approached by an adversarial acquaintance. Our physicians are people too, and it’s in everyone’s best interest to have a healthy relationship based upon mutual respect and trust. This doesn’t mean everyone has to always agree; but it does mean that we can have healthy discussions not just to celebrate the wins along the way, but to even discuss the difficult stuff and ask legitimate questions, being willing to hear our physician’s response. Our experience – and that of our physicians – is improved when we take the time to cultivate a healthy relationship, they know us by name, they know our history, we respect their knowledge and expertise, etc. We have a part to play in this regard, and we should do it willingly and with grace.
3. Do what you know to do, then follow the treatment plan
Patient non-compliance can be utterly exhausting. One doctor I talked to stated it this way, “Don’t pretend to agree if you won’t follow through.” This is so true. Ask any doctor about those patients who never follow the treatment plan, and she will tell you that she cannot understand why the patients continue to schedule appointments. You know, that makes sense to me.
We know to do many things, like eat healthy meals and exercise when possible. Yet, we don’t do this. Even when our physician gives us a written plan of care, we often don’t do what she tells us to do. Noncompliance results in additional appointments, additional phone calls and other duplicate steps being necessary to try and keep us out of the hospital.
It’s discouraging for anyone to put time and effort towards a goal and never see any real progress. I’m not saying to take a hands-off approach and without ever asking questions, robotically do what a physician tells you to do. We absolutely should ask questions, express our concerns, ask for adaptations to the original plan, or express any need for input or clarity that we might have. Our doctors want us to do this. Physicians want us to be clear on what they’re telling us. They want us to have input into our care.
So, once you’ve done a quick recap to the physician about what you’re supposed to do and have had your questions answered, then do what the doctor says to do. It will greatly encourage your physician, will keep you engaged in your care, and most importantly, will come closer to keeping you healthy and out of the hospital
4. Be sensitive to the length of the visit
This one is tricky. It makes sense on the surface, but is often hard to implement. As we develop a friendly, teamwork relationship with our physicians, we naturally will want to share things about our life, like how our family is doing, our kids graduated, we just became a grandparent, and the like. Some of this cordiality is a good thing, but it can easily chew up the clock. Let your doctor guide this, and don’t be offended if she cuts to the chase. Much of physician time is spent outside the actual exam, so where you can, be brief and to the point – though certainly never curt – and minimize chit-chat unless it’s physician-directed. Come prepared to the visit with your med list, symptoms log, and short list of questions or topics to discuss. Try to avoid the oh-by-the-way questions as you walk out the door. I’m not a proponent of fast-food medicine by any means, and it certainly is challenging to fit a year’s worth of chronic health issues into two brief 20-minute, 6-month checkup sessions. But being respectful of the nurse’s and physician’s time shows great respect and encourages the team tremendously.
5. Be honest
Honesty is always a good idea, of course, but is especially necessary when dealing with our physicians. They cannot help us if they don’t know what the problems are. If there is a new symptom, please, open up and say something. Ditch the pride on this, there’s no shame in asking for help or reporting a new problem. Our doctors want us to keep them informed as new symptoms arise. By the same token, be honest about the severity of things and avoid symptoms magnification/hyperbole. It takes double-time to get past it to the true explanation of what’s really going on. Keep an honest check on our effort and grit. Be sincere and truthful with your doctor when you’ve fallen off the bandwagon and need some help getting back on track. Keeping our grit in check and being willing to ask honesty for help when needed go a long way to show an honest effort towards completing our part of the plan. Chronic illnesses will wear you out, and it’s easy to fall into seasons marked by decreased effort. Most physicians will be our cheerleaders, but to do this excessively will wear anyone out. Being honest when we need help and implementing gentle accountability on our effort level builds mutual trust on the team.
6. Be kind
Kindness is free, and yet it is largely absent in much of our culture today. I’m puzzled and perplexed by this. Nonetheless, one way to encourage our physicians and help prevent burnout is to simply be kind. Be nice to the doctor and his staff. Being kind to the doctor won’t feel very kind if we just fussed out his front office staff right before the visit. Even awkward discussions like, “I’m not sure I want to have that test,” or “I’m not fully on board with this med,” can be approached with kindness and respect. It makes for a more positive experience for everyone and that’s a win-win.
7. Be patient
This is hard. Waiting in the waiting room for hours when you don’t feel well can be maddening. Be mindful of the many things that go on behind the scenes that we patients don’t see; phone calls and consults, paperwork ad nauseum, fighting for insurance and PBM approvals, emergency calls from the hospital – even personal emergencies arise from time to time, and we never know when something has happened right before we arrived. Instead of using the wait time to fume up into anger and clobber the doctor when he enters the exam room, take a deep breath and assume something’s going on that we don’t know about. Feel free to express your concern to your doctor in a kind way, and if necessary, re-schedule the appointment. But the worst thing that can happen is to start your visit with 5 or 10 minutes of verbal vomit because we had to wait. It could be that the patient next to you just passed away and the staff has been dealing with the protocol for those situations. If there is a scheduling problem or a front office issue that’s causing repeated delays, have a kind discussion with your physician, she would want to know of any issues so they can be addressed. Caring enough to discuss delays in a healthy way while keeping a posture of patience encourages our physicians and let them know we appreciate the long hours they work.
8. Know what meds you take and why
We Chronies see lots of physicians and it’s easy for changes in one office to not appear in another office. Usually the nurses reconcile the med list, but knowing what meds we actually take and why we take them tremendously speeds up the process. Be familiar with prescription meds and over-the-counter ones alike, even aspirin or vitamins. It all matters. A good idea is to take a picture of each bottle of medication and have it on your phone before your visit. This will eliminate any uncertainty about medication names, dosages, who prescribed it, etc. Long gone are the days when “a little white pill” was an acceptable medication description. Knowing why we take a certain med is especially important if we take it for a non-conventional use. For example, I take Provigil for low blood pressure from the Sjogren’s and dysautonomia. Provigil is actually an ADD med, so it helps my docs best coordinate my care if I can tell them that I take this for low BP, not ADD. There’s no guessing and no searching through the record, saving time and keeping things simple. Trust me on this one – your physicians will thank you for being knowledgeable on the medication list thing and keeping it simple.
9. Be a good historian
The value of a patient’s knowledge about their medical history cannot be overstated. If the patient is unable to give a detailed history of symptoms, a well-informed family member or friend is an excellent substitute. Bringing good knowledge of the course of our illnesses, the history and progression of symptoms, what’s worked well in the past and what didn’t work so well, and other details of our journey makes the visit quicker and simpler for both us and the physician. While we don’t want to slip into verbosity and idle chit-chat or medical jargon, a concise, all-inclusive bullet-point history goes a long way to making our visit a positive one, both for us and for our care team. It’s often time-consuming to go through medical records and try to put the whole story together, especially when there are literally boxes of notes, much of which is EMR-gobbly-gook that is meaningless, redundant and time-consuming. Assisting the doctor here is quite helpful and saves lots of time and energy.
10. Have a good handle on the admin side of your journey
Anything – ANYthing – we can do to help minimize what’s required of the physician and his staff in this regard will be greatly appreciated. It saves time, keeps the patient engaged, and avoids extra steps for the clinic staff. Know your insurance plan. Know what’s in and out of network. Stay on top of errors in your record and make timely requests of the clinic staff to help you fix them. Consolidate paperwork requests, or print from the patient portal when possible. If your physician allows a patient portal for contact, use this instead of leaving phone messages that often lead to endless phone tag. The entire medical staff is already buckling under ridiculous insurance and PBM requirements, so anything we can do to help shoulder some of the admin load will help ease this over-sized burden and help our doctors out.
Physician burnout affects us all.
It can lead to lower patient satisfaction and quality of care, higher medical error rates, higher physician turnover and drop-out rates and a host of other disastrous issues that negatively affect everyone in the healthcare cycle. One of the kindest things we can do as patients is to return the favor and take care of those who take care of us. While it’s true that the biggest triggers of physician frustration really aren’t the patients, we can still take even small steps to show gratitude and thanks. It’s not only good for the doctors, but good for us because it fosters healthy relationships and keeps us engaged in our care.
Blessings, my friends. Keep on keeping on and remember… be good to our doctors and patient care team. It’s the right thing to do – and we kinda need them.