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Physician Burnout from Value-Based Care: Why CMM is Needed

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There was recently some good news about physician burnout. As an American Medical Association report notes, citing the results of a triennial study published in Mayo Clinical Proceedings, "For the first time since 2011, the physician burnout rate has dropped below 50% among doctors in the United States. …  The study found that 43.9% of U.S. physicians exhibited at least one symptom of burnout in 2017, compared with 54.4% in 2014 and 45.5% in 2011."

Unfortunately, this data should not be celebrated too much. As AMA President Barbara McAneny, MD, states in the report, "The tide has not yet turned on the physician burnout crisis. Despite improvements in the last three years, burnout levels remain much higher among physicians than other U.S. workers, a gap inflamed as the bureaucracy of modern medicine interferes with patient care and inflicts a toll on the wellbeing of physicians."

The reality is that physician burnout has long been a problem facing doctors and their organizations as well as the patients and communities they serve. The shift toward value-based care has likely not helped improve burnout and, as one author notes, probably "added fire" to it.

While there's no single solution to physician burnout, pharmacist-driven comprehensive medication management (CMM) is one service that can help in numerous ways. This is apparent when one examines the factors that contribute to physician burnout, many of which were identified in the "Medscape National Physician Burnout & Depression Report 2018," assembled from insight provided by more than 15,000 physicians from 29 specialties.


How Comprehensive Medication Management Reduces Physician Burnout

Here are some of those factors, which are directly or indirectly impacted by the migration to value-based care, and how CMM can help reduce their negative effects on physicians.

1. "Too many bureaucratic tasks."

Easily the most common factor cited by respondents, with 56% of physicians saying that these tasks, like charting and paperwork, contribute to burnout. But such tasks are critical to improving outcomes while decreasing the quantity of tests and services patients must receive. CMM can reduce the number of these tasks as well as the time spent on them by physicians. Examples of medication management tasks that can be shifted in part or completely to a pharmacist include:

  • securing, documenting, and maintaining medication history;
  • organizing patient medication data;
  • Identifying drug therapy problems
  • formulating a CMM assessment and plan; and
  • revising the care plan.

While physician involvement in some of these and other CMM tasks remains critical to ensuring optimal outcomes, pharmacists can help decrease physician workload and possibly improve care in the process.

2. "Spending too many hours at work."

Long workdays and workweeks can burn anyone out, and physicians are no different. This is the second most common factor cited in the Medscape survey, with 39% of respondents acknowledging the negative effects of working too much. Value-based care has the potential to add work for physicians without patients experiencing a benefit — at least that's what a majority of clinicians believed in 2017, according to a joint American Academy of Family Physicians and Humana study.

Alleviating some of the medication management work currently on many physicians' plates may allow physicians to cut back on their work hours. CMM alone may not be enough to make a significant impact on physician hours worked, but it can serve as one of several ways that physician workload can be reduced.

3. "Feeling like just a cog in the wheel."

While value-based care is supposed to encourage greater collaboration, physicians may find it difficult to take the lead on better engaging other key stakeholders involved in a patient's care. A Geneia survey of physicians found that 86% of respondents agreed that "the heightened demand for data reporting to support quality metrics and the business-side of healthcare has diminished my joy in practicing medicine." This can contribute to physicians feeling like they are "just a cog in the wheel" of healthcare — which was identified as a contributing factor for burnout by 21% of Medscape survey respondents.

Collaboration is vital to CMM. As an article from the Institute for Patient Access notes, "Where patient care lacks collaboration, a number of problems can ensue: sub-dosing, overdosing, prescription drug interactions, or improper prescription drug selection due to unknown patient factors."

Pharmacist-driven CMM can alleviate some of the responsibility for physicians to drive engagement. The collaborative nature required for effective CMM may also provide physicians with a rewarding feeling of participating in teamwork that is focused on improving their patients' wellbeing.

4. "Lack of respect from patients."

Another interesting statistic from the Geneia survey: 87% of physician respondents said they find it is increasingly difficult to spend time "developing an authentic engagement with each patient." Contributing factors likely include some of the key contributors to successful value-based care, such as increased data collection, analysis, and reporting. Unfortunately, when more time is spent on responsibilities that do not involve direct interaction with and support of patients, that can lead to what physicians perceive as a lack of respect from their patients, as noted by 16% of Medscape survey respondents.

CMM, by reducing bureaucratic task workload, can provide physicians with more meaningful time to spend with patients, strengthening the physician-patient relationship. Furthermore, the collaborative nature of CMM may make patients feel like they are receiving the individualized care they deserve. This will likely increase their satisfaction with the various providers, including physicians, working to improve their quality of life in the most efficient and cost-effective ways possible.

Whitepaper: Medication Management Challenges and Opportunities for Payers and Providers


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