{"id":44,"date":"2017-12-04T19:50:22","date_gmt":"2017-12-04T19:50:22","guid":{"rendered":"https:\/\/nam.edu\/clinicianwellbeing\/?page_id=44"},"modified":"2018-04-10T10:57:41","modified_gmt":"2018-04-10T10:57:41","slug":"rules-and-regulations","status":"publish","type":"page","link":"https:\/\/nam.edu\/clinicianwellbeing\/causes\/rules-and-regulations\/","title":{"rendered":"Rules and Regulations"},"content":{"rendered":"

Accreditation, licensure, insurance policies, reimbursement, and litigation risk can add pressure and stress for clinicians and may significantly impact when and how clinicians experience burnout.<\/p>\n

Accreditation and Licensure<\/h3>\n

State medical boards and accrediting institutions may significantly hinder clinician\u2019s ability to seek help for burnout and other mental health conditions. Two-thirds of states require physicians to report mental health conditions to state medical boards regardless of impairment, and despite national concern about physician well-being and suicide, many physicians are reluctant to disclose and seek treatment<\/a> because it could have negative consequences when they apply for their license. Fear of negative consequences is not unfounded. A recent study found that states are more likely to ask for history of treatment and prior hospitalizations for mental health and substance use<\/a>, compared with physical health disorders, even when mental health disorders are not causing impairment. Seeking mental health services can be overwhelming for clinicians in part to due anxiety about licensure, credentialing, and hospital privileging. State medical boards tend to ask physicians broad questions that intrude on privacy and do not necessarily identify impaired physicians. The American Medical Association recently approved a policy<\/a> asking state medical boards to refrain from asking applicants about a history of mental illnesses and substance abuse treatment and to focus only on current impairment by mental illness or addiction. Some dental and nursing state licensing boards ask similar questions about mental health and could follow similar lessons in focusing on current impairment instead of past history. Health care organizations can also consider offering third-party options for clinicians and other health care professionals to seek help in non-punitive ways.<\/p>\n

Insurance Policies, Reporting, and Reimbursement<\/h3>\n

A major cause of burnout seems to be myriad administrative tasks that clinicians must endure in order to be reimbursed and to prove that they are effectively tracking patient care. In a recent survey, 23% of physicians reported that they and their staff completed more than 40 prior-authorization requests in the week before taking the survey, amounting to more than 20 hours per week completing such requests<\/a>. Not only do these requests result in an enormous time suck for many clinicians, physicians and nurses alike, they often delays patient access to necessary care. Ultimately, pre-authorization remains a draining burden that disrupts workflow and pulls clinicians away from patient care. Recently, the American Medical Association and a coalition of 16 other organizations issued a comprehensive set of 21 principles designed to reshape the pre-authorization process<\/a>.\u00a0 The implementation of these principles can make way for clinicians to have more time with patients, less paperwork, and ultimately, better patient care.<\/p>\n

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Documentation for reimbursement is also tied to burnout. For every one hour of face-to-face care, physicians spend two hours documenting<\/a> to meet billing requirements. The design of electronic health records has not made this easier. In fact, computerized physician order entry is an independent predictor of burnout<\/a>. Additionally, in the last decade, the number of quality measures directed at health care organizations by Medicare, Medicaid, and private health insurers has skyrocketed. There are thousands of measures in use today<\/a> and a clear lack of consistency, compatibility, reliability, focus, and organization. In a recent study, researchers found that physician practices spent an average of 785 hours per physician<\/a> and more than $15.4 billion dealing with the reporting of quality measures to report to Medicare, Medicaid, and private health insurers. These measures are used as a basis for financial \u201cpay-for-performance\u201d incentives to physicians. More than 159 measures of outpatient physician care are now available and reporting on these measures imposes a considerable burden to medical practices. While the health system has much to gain from quality measurement, the current operation is not efficient and encumbers clinicians from providing care. To achieve better health at lower cost, leadership must prioritize efforts to reduce the number of measures and standardize their use across the health system. The less time clinicians have to spend reporting on measures, the more they can focus on providing patients with the best care possible.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Accreditation, licensure, insurance policies, reimbursement, and litigation risk can add pressure and stress for clinicians and may significantly impact when and how clinicians experience burnout. Accreditation and Licensure State medical boards and accrediting institutions may significantly hinder clinician\u2019s ability to seek help for burnout and other mental health conditions. Two-thirds of states require physicians to […]<\/p>\n","protected":false},"author":35,"featured_media":0,"parent":11,"menu_order":6,"comment_status":"closed","ping_status":"closed","template":"page-topic.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-44","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/pages\/44","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/users\/35"}],"replies":[{"embeddable":true,"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/comments?post=44"}],"version-history":[{"count":0,"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/pages\/44\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/pages\/11"}],"wp:attachment":[{"href":"https:\/\/nam.edu\/clinicianwellbeing\/wp-json\/wp\/v2\/media?parent=44"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}