Rules and Regulations – Clinician Well-Being Knowledge Hub

Taming the EHR

NAM — Mon, 13 Dec 2021 13:57:56 +0000

This webinar is part of AMA’s Taming the E.H.R. series, teaching participants tips and tricks to save time fulfilling documentation duties.

Measuring Our Values – Redoubling on a Commitment to Physician Health

NAM — Mon, 09 Sep 2019 16:11:36 +0000

Among the most telling statistics, suicide is the second leading cause of resident physician death. Growing health care costs, worsening physician shortages, along with a growing population needing health care, are factors to rethink in providing valuable physician training programs. The New England Journal of Medicine published a study that surveyed residency programs. Policies that allowed “flexible” duty hours (did not specify limits on shift length or mandatory time off between shifts) had negative impacts on overall well-being. Efforts should be made to ensure that trainees have the flexibility in their schedules to access mental health resources. The organizational and systemic factors that contribute to adverse mental health outcomes is a primary focus for physicians at all levels.

Medical Licensure Questions and Physician Reluctance to Seek Care for Mental Health Conditions.

NAM — Mon, 09 Sep 2019 16:03:18 +0000

Licensing boards inquiring about mental health diagnoses are believed to cause a substantial deterrent to physicians seeking help, especially those with treatable disorders. This study, conducted by the Mayo Clinic sought to determine whether state medical licensure application questions (MLAQs) about mental health impact a physician’s reluctance, to seek help for a mental health condition. Responses from the applications for questions regarding mental health were collected, along with data on care-seeking attitudes, from a convenience sample of U.S. physicians. Results found that nearly 40% of physicians would be reluctant to seek care for treatment of a mental health condition due to concerns of repercussions. Changing medical licensure application questions so that they inquire about current functional impairment could provide a meaningful step to reducing barriers to seeking assistance.

Physician Burnout in the Electronic Health Record Era: Are We Ignoring the Real Cause?

NAM — Thu, 15 Aug 2019 20:40:55 +0000

Published in the Annals of Internal medicine, the following article discusses the impact of electronic health records (EHRs) on physician’s interaction with patients and on clinician burnout. Although EHRs have great potential to improve care, they may also have perverse effects. Some studies suggest that U.S. physicians now spend as much time on “desktop medicine” (interacting with the computer) as they do face to face with patients. Providers must divide their attention between patients and the EHR, compromising patient–physician relationships. Although few physicians support reverting to paper, there is a growing sense within the medical community that the EHR is driving professional dissatisfaction and burnout.

How Tech Can Turn Doctors into Clerical Workers

NAM — Thu, 15 Aug 2019 20:31:15 +0000

The following article, published in The New York Times Magazine, examines the threat that electronic health records and machine learning pose to physicians’ clinical judgment–and their well-being. Although the EHR has reduced medication errors, made notes legible, and combined laboratory and imaging information, it was never built with any understanding of the rituals of care or the user experience of physicians or nurses. True clinical judgment is about using human skills to understand the patient’s trajectory in life and in disease, as well as the nature of the patient’s family and social circumstances.

The Burnout Crisis in American Medicine

NAM — Thu, 15 Aug 2019 20:30:00 +0000

The following article, published in The Atlantic, explores the contribution of electronic medical records and demanding regulations to a historic doctor shortage. For many doctors, attention is often consumed by challenges of coordination rather than patient care, and patients will often experience delays not for any medical reason, but simply because of an inflexible computer system and a poor workflow. The increasingly high demands of regulations and operations of medicine consume doctors’ practice, and leads to burnout and high turnovers. A health-care organization’s success, in the years ahead, will depend on its success at delegating responsibilities among physicians and non-physicians, training the non-physicians to do their work independently, and empowering everyone—not just doctors—to shape a patient’s care and be accountable for the results.

We’re a Bunch of Expensive Financial Clerks

NAM — Thu, 15 Aug 2019 19:16:09 +0000

Brent C. James, MD, MSTAT, explains an experimental next-generation electronic medical record that uses activity-based design. Like an electronic clinical scribe, a doctor can talk about what he or she is doing, and the computer system captures it and coverts it into automatable computable data. The original intent of EMRs was not financial, yet the current iteration is used to generate maximal fee-for-service billing, and that’s the reason physicians spend 2 hours at a computer for every hour they spend with patients. According to James, the system currently serves “a bunch of very expensive financial clerks” and should be redesigned for physicians.

Teaching Physicians to Get a Break on a Burdensome Task

NAM — Thu, 25 Jul 2019 13:57:45 +0000

The following article reports on the Center for Medicare and Medicaid Services’ new policy, which eliminates the need to re-do medical students’ input to health records. Instead physicians will be able to refer to student notes as part of their own documentation. This rule will not only eliminate unnecessary work, but also emphasize the value of student’s input into the health record.

Your Best Life: Resiliency Builder: Delivering Orthopedic Care Abroad

NAM — Thu, 25 Jul 2019 13:36:36 +0000

The following article in Clinical Orthopaedics and Related Research posits how practicing Orthopaedics abroad may intuitively enhance resilience. With less resources, the surgeon may exercise more autonomy and use pure surgical skills and knowledge of basic fracture principles. Furthermore, the surgeon is able to prioritize the patient with less administrative burden, thereby allowing a direct and profound impact on the community. The authors urge surgeons to learn more about and consider opportunities abroad in an effort to develop satisfaction and resiliency.

Shell-shocked. Looking Out for the Well-Being of Physicians–Particularly in this Malpractice Environment–is the Mark of a Professional Medical Practice Manager

NAM — Mon, 22 Jul 2019 19:36:20 +0000

The following discusses the unwritten role of the practice administrator in supporting the doctor during malpractice lawsuits. To effectively run an organization, the article argues for the necessity of support in work environment and encouragement of open discussion about malpractice long before lawsuits occur.