Although reports of physician burnout multiplied during the COVID-19 pandemic, it has always been a problem in health care According to a study from the Mayo Clinic, the COVID-19 pandemic only exacerbated existing problems in the healthcare delivery system and took a toll on the U.S. physician workforce This added strain impacted the quality of care, resulting in turnover and reductions in work effor . The Association of American Medical Colleges also estimates that the U.S. could see a shortage of 54,100 to 139,000 physicians by 2023 which is expected to plague both primary and specialty fields.
Physician and nurse burnout remains a critical issue across all aspects of health care because it affects the quality of care, cost efficiency, and accessibility to care Burnout among providers can lead to poor patient interactions, patient dissatisfaction, and medical mistakes.
In fact, 2021 saw the largest-ever exodus of physicians in the United States, with an estimated 333,942 healthcare providers leaving their jobs, according to Definitive Healthcare. These labor shortages can reduce care accessibility and even result in facility closures, removing access to care for communities with already limited resources, like rural communities.
If you have tried to see a doctor in the last year, I'm positive you have been on hold for hours trying to make an appointment, and the days of same-day appointments are few and far between. I have seen many #urgentcare clinics set up to close the gap for patient needs. I've also seen medical groups consolidate in some cases three times since the pandemic. (small doctor practices joining an umbrella of a larger group or hospital system),
You are also seeing what I would call physician punting. I recently went to a doctor to get a script for a #mammogram , as I was overdue I have a 2-inch medical history. Given I had not been to a #gynecologist in many years, I brought up some other things, including the fact that my mom died from ovarian cancer and I was told, "you are only here for a screening," and if you want to discuss anything else that I needed to make an appointment. This was the first time I had seen this kind of behavior outside of an emergency room.
Healthcare #burnout is happening for various reasons, and it is not all covid-19 related. . Internal corporate mandates, lack of autonomy, work/life balance and unsustainable patient visit volume expectations (fee for service) models are all part of the problem. I have spoken to physicians who are no longer "having fun" with their jobs and how it is all about the bottom line and transactional in nature.
Value-based healthcare changes the patient/doctor relationship. Rather than having the physician being asked to see a patient every 10 minutes and or carrying employer-required caseload numbers, doctors are incentivized and paid on the quality of their treatment and outcome vs. the number of visits. It should ultimately improve patient outcomes and reduce expenses for the parent company.
"Essentially, providers are paid based on the quality of care provided, rather than the quantity of patients they see. The transition from fee-for-service or volume-driven health care to value-based care is a clear path to helping alleviate the conditions that create physician burnout. "
"Now, after years of experimenting, cajoling, and incentives, value-based payment models — those tied to patient outcomes and spending targets — seem to be gaining traction. According to the Health Care Payment Learning & Action Network’s (LAN) annual measurement of participation in alternative payment models, slightly more than 60% of health care payments in 2020 included some form of quality and value component. That is up from 53% in 2017 and 11% in 2012."
"Similarly, 49% of practices responding to the American Academy of Family Physicians (AAFP) 2022 value-based care survey said they are participating in some form of value-based payment, and 18% are developing the capabilities to do so."
I love the idea of value-based healthcare as it should reduce physician burnout and allow physicians have the proper time with their patients as well as better outcomes for the patient. In the big picture that is what they signed up to do. Help, heal and treat the sick.
It also gives them skin in the game. Value-based care, physicians are paid according to quality and efficiency, as opposed to the fee-for-service model, which pays doctors based on volume of services and often results in unnecessary procedures and higher costs.