by Paul Batson, O.D. Center Director VisionAmerica of Birmingham I spent about two hours yesterday reviewing the 2018 MIPS guidelines and requirements. The longer that I spend walking through these topics, the more frustrating it becomes. Who in their right mind would create such a complex system of reimbursement? The hoops that we jump through for things like MIPS are just one of the many complexities of practice that lead folks to want to "throw in the towel." I've talked with more and more folks lately that feel the same way. As I thought about it, my mind wandered to the topic of how we avoid burnout. On January 31st, 2017, the American Medical Association published an article titled "Reports Reveal Severity of Burnout by Specialty." (Click here to read the full article.) The article contained results from a Medscape survey that graded the severity of burnout across medical specialties. It probably isn't hard to believe that emergency medicine practitioners ranked number one with a burnout rate of 60%. A 2011 study by the Department of Medicine Program on Physician Well-being at Mayo Clinic found that 45% of all U.S. Physicians suffered from at least one symptom of professional burnout with that number rising to 54% in 2014. This study also found that physicians worked a median of 10 hours more per week (50 hours vs. 40 hours), displayed higher rates of emotional exhaustion, depersonalization, and overall burnout (48.8%), while also reporting a lower satisfaction with work-life balance (36% satisfaction for physicians compared to 61.3% for the general U.S. working population). But what is burnout? The Agency for Healthcare Research and Quality defines burnout as a "long-term stress reaction marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment." Dr. Dike Drummond, widely considered one of the foremost experts on the subject of physician burnout, uses the metaphor of an energy account when speaking on the topic. He states that "Like a bank account, it can have a positive or negative balance. You withdraw energy from this account for the activities of your life and medical practice. You deposit energy into this account during times of rest and rebalance. When you dip into a negative balance, the account does not get closed. You keep spending (or working) despite the fact that your energy account is depleted." Using Dr. Drummond's metaphor, we can take something as vague as "burnout" and make it a simple math problem. If your job and personal life take more out of you than you can put back into yourself, you will ultimately end up suffering from burnout. Below are three tips we hope will help you replenish your "energy account" and maintain a healthy work-life balance for the sake of your career and loved ones. Make your work, work Being a doctor is an extreme balancing act. It's difficult. In our recent piece on physician time management (Read it here if you missed it.) we stressed the importance of utilizing your staff. Though it may not be easy to do, delegating small, non-medical tasks to support staff is as essential to a successful practice as it is your health. We say "make your work, work," but what we are really saying is, "Trust your staff to share the workload." There are things in your practice that only you can do. Do those and do them well. For everything else, delegate to your current staff or, if necessary, go hire the right person for the job. Hire a great leader Being a doctor is an interesting thing. You go to college and then to optometry school to learn medicine. Once you step out into practice, it is assumed you know how to run your own practice and manage people. It isn't that simple, though. There are many lessons to learn when it comes to business management and leadership and handling those duties along with practicing optometry is an extreme burden. This is why hiring a great leader is so important. But hiring a leader isn't enough. They have to be allowed to lead! As we noted above, there are tasks in the practice that can be designated to and completed by support staff. The same is true for leadership and management duties. As doctors, we don't have to be at every meeting and dot every "i" and cross every "t." Hire someone capable, set clear expectations, and trust them to do the job well. Set a reasonable workload This is a tough one. The combination of new hurdles for medical and optometry practices and the introduction of new technology have created increased workloads for medical practices. If you aren't following the advice above, the workload is likely falling squarely on your shoulders. Doctors are arriving earlier, staying later, and then taking charts home to transfer information in the EHR while neglecting their personal health. There is really no silver bullet when it comes to this issue. Sure, you will likely get more efficient with the technology you implement in your practice, but working longer hours for the sake of maintaining the numbers of your practice simply isn't sustainable. If the balance (or lack thereof) is getting to be too much, there are really only two choices:
These are tough decisions because they impact the practice's bottom line, but they will likely pay off in the long run. We plan on exploring this topic more in the upcoming months, but would also like to hear from you. If you are struggling with burnout or have thoughts on the topic, please reply to this email and let us know!
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