How the Patient-provider Encounter Drives Patient Satisfaction

Understanding Physicians in Order to Boost Patient Satisfaction

A-Day-in-the-Life:

We previously discussed the importance of your key players (physicians) in creating a culture within your healthcare facility that leads to improved patient satisfaction. There’s no doubt about it – patients’ opinions of a healthcare facility are largely developed during their interactions with their physicians. However, the role of the physician has become complicated these days. In order to set your physicians up for success in a way that positively affects patients, it’s worth investing the time to gain an understanding of their day-to-day life, including some of the obstacles they face.

Dermatology Times article, “2021’s Top Challenges Facing Physicians,” highlights the results of Medical Economics’ Physicians Report performed late last year in which physicians were asked what they thought would be the most challenging issues they will face in 2021. (1) I’d like to use this article as a guideline for today’s Thinking Thursday TIPs, as it provides some great insight into the day-to-day life of a physician.

Administrative Burdens and Paperwork

It’s no surprise that the first projected challenge of 2021 physicians listed is paperwork. It’s inescapable, especially with today’s growing model of treating patients via several different avenues such as telehealth, in-person, or over the phone. However, there are ways to alleviate the burden of administrative work on physicians. Norcal Group provides a helpful article titled, “Solutions to Reduce EHR Burdens and Decrease Physician Burnout.” (2) Here are the ten tips they list in summary:

Work with IT staff to improve EHR usability.
“IT department staff (or vendors or consultants) can most likely improve the usability of an existing system for an individual physician.” (2)
Convince administrators and physician leaders that EHR usability issues require solutions.
“Clinicians need to convince administrators and leadership that there is a problem with the EHR and that the problem is solvable.” (2)
Create the market force to drive a more physician-centric EHR by demanding that EHR developers and designers make systems more clinically relevant.
“Promising technologies for focusing EHR on end-user value and usability are in development…. [E]ducate EHR developers and designers about clinician EHR needs.” (2)
Support organizations advocating for EHR clinical relevance and usability.
“Legislators need the wisdom and creativity of physicians to transform EHR-related legislation.” (2)
Use a live or virtual scribe.
“Scribes can reduce burnout in a variety of ways, including: decreasing physician data entry requirements, decreasing feelings of isolation, and increasing physician engagement with patients.” (2)
Share data collection duties with others.
“Sharing clerical tasks can result in each team member working at the top of his or her skill set.” (2)
Develop EHR expertise.
“Research indicates that physicians with adequate EHR training are significantly more satisfied with their EHR system.” (2)
Improve EHR patient engagement skills.
“The EHR system can be transformed from an intrusive burden into a patient engagement tool.” (2)
Talk to colleagues directly.
Choosing a direct conversation can alleviate feelings of isolation associated with EHR.
Focus on the positive.
“So much is wrong with EHRs in everyday practice that it is difficult to step back and appreciate the benefits EHRs have to offer.” (2)

Getting Paid and Seeing Enough Patients:

Returning back to the previously mentioned Dermatology Times article, the second proposed challenge physicians list in Medical Economics’ Physicians Report is getting paid and seeing enough patients. Authors write, “Getting paid is regularly listed as a top challenge facing physicians, according to the 2020 Medical Economics Physician Report. The good news for physicians who primarily deliver office and outpatient services is that the Centers for Medicare & Medicaid (CMS) has made significant changes to evaluation and management (E/M) coding and documentation to make the process simpler.” (1)

The article lists three areas physicians need to focus on going forward to make sure they get paid:

Understand E/M changes.
“According to coding experts, E/M codes are now much simpler Physicians will not select an E/M code based on total time spent during the encounter or medical decision making, whichever one pays more.
Physicians now get credit for many tasks, including reviewing and interpreting test results, speaking with family members if a patient cannot provide their own history, and discussing patient treatments with another health provider or other professional involved in their care.
Physicians should contact their payers to verify whether they will adopt the CMS changes. Some payers may continue to require code selection based on history, exam, and MDM. They may also have requirements for individual codes.” (1)
Master telehealth payments.
“Experts say physicians must balance keeping telehealth available for patients who are not comfortable coming into the office to capture as much revenue as possible, knowing that at some point in 2021, it’s likely that reimbursement for it may dry up.” (1)
Embrace the data.
“Experts say fee for service (FFS) isn’t going to vanish in 2021, but more contracts will focus on value-based care, and the lifeblood of any value-based care contract is data. Payers want data to evaluate the most effective physicians, and the top performers get the best bonuses.” (1)

Physician burnout and Autonomy

As part of the Medical Economics Physician Report, seventy-one percent of physicians reported feeling burned out – thirty-one percent saying their burnout was due to too much paperwork and government/payer regulations, fifteen percent citing poor work-life balance, and twelve percent saying their burnout was due to the COVID-19 pandemic. (1) As discussed heavily in last week’s Thinking Thursday TIPs, burnout is a huge hindrance to physician engagement and elicits the concern of healthcare facility leaders.

Howard Baumgarten, LPC says there are three categories of physician burnout: physiological (presenting as physical symptoms), mental/emotional (presenting as anxiety or depression), and behavioral (presenting as increased alcohol or tobacco use, overspending, or decreased sleep). (1) He lists four suggestions to combating burnout at the first onset of symptoms:

Sleep Hygiene: getting 7-8 hours of sleep with consistent sleep and wake times. Also, avoid alcohol and screen time before bed.
Exercise: 30-40 minutes of aerobic exercise 4-5 times per week with additional, occasional muscle building work.
Avoid sugary and fried foods
Do something that makes you feel good like a hobby.

Lack of Autonomy and Career Control:

Eleven percent of physicians contributed their burnout to the lack of autonomy and career control. (1) President and co-founder of Moral Injury of Healthcare, Dr. Wendy Dean, empathizes with fellow physicians: “[F]ollowing the long hours of rigorous training, focusing on independent, critical thinking with strict adherence to algorithms based on reimbursement policies can be grating.” (1) When we’re talking about the topic of autonomy, there’s no doubt there are many systemic hurdles that must be crossed, yet are out of reach. Dr. Dean goes on to encourage physicians to, “Understand how reimbursement happens, what the incentives are at their entity, and whether they can negotiate to build bridges with the administration, build bridges with other licensees so that everyone can work together to start fixing things at the local level.” (1)

Patients’ Biggest Advocates

In a way, the physicians of a healthcare facility really gauge the overall “temperature” of the entire entity. In order to create and foster a culture within the facility that results in improved patient satisfaction, it’s crucial to gain an understanding of your physicians and their daily needs. I’ll leave you with a quote from Health Leaders’ article, “Physician Advocate: Coronavirus Pandemic Shows Need to Ease Regulatory Burdens,” “To create a patient-focused industry that fosters improved health outcomes, physicians should have influence in reforms that address inefficient electronic health records and ever-changing practice and payment models, as physicians are patients’ biggest advocates. Especially during the COVID-19 pandemic, policies that are physician-informed will increase efficiency in practices and emphasize patient safety and outcomes.” (3) Making strides towards understanding your physicians and working to alleviate some of their daily hindrances will empower them to support the overall goal of improving patient satisfaction.

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Thank you!
Jerry

Jerry L. Stone
Co-Founder/COO
MedicalGPS, LLC

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