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The challenges that private practice physicians face and solutions from the American Medical Association. Sea Chen, MD, physician director of the Practice Sustainability Group at the AMA, discusses how the AMA is helping independent physicians with burnout, practice management and improvement, and learning the business skills to start and grow their practice. AMA Chief Experience Officer Todd Unger hosts.
- Access the AMA STEPS Forward®Private Practice Playbook and download the playbook’s "Sample Forms"
- Read the AMA STEPS Forward®Getting Rid of Stupid Stuff toolkit
- Listen to "Private Practice: Attending to Business" podcast episodes on AMA Ed Hub™.
- Learn more about the AMA Recovery Plan for America’s Physicians.
- The AMA is your powerful ally in patient care. Join now.
- Sea Chen, MD, physician director, Practice Sustainability Group, AMA
Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about three challenges that private practices face and how the AMA is helping to address them. Joining me today in our Chicago studio is Dr. Sea Chen, physician director of the practice sustainability group at the AMA. I'm Todd Unger, AMA's chief experience officer. Dr. Chen so great to have you today.
Dr. Chen: Thanks for having me. I'm looking forward to the conversation.
Unger: It's really nice to have folks here in our Chicago studio. And I'm excited too because you're a relative newcomer to the AMA. Tell us a little bit about how you landed here.
Dr. Chen: So I've been practicing in private practice for a while, then joined a big group in Kaiser Permanente and then came back to private practice. And, unfortunately, things in private practice were getting worse and worse. And so, I decided to leave. I got a little bit burnt out. So it was a great thing that I found this opportunity at the AMA. And it's been wonderful since I've gotten here. And I want to really, really help my fellow colleagues that are still out in practice not burn out.
Unger: Well, then, this is a perfect conversation today because we've been talking a lot about the AMA's Recovery Plan for America's Physicians. We talk a lot about Medicare payment reform. But one of the other key pillars, of course, is physician burnout. This is something that obviously affects both new and longtime physicians in private practice. Let's talk specifically given your experience what are some of those kind of unique challenges that affect private practice physicians in regard to physician burnout?
Dr. Chen: Well, Todd, I think first I'd like to say that private practice, which we're defining as independent physician-owned practices—it has been a pillar of the medical community in the United States. And we at the AMA are dedicated to supporting private practice as an option for physicians who want to practice in that setting. One of the main appeals of private practice is, of course, that you get more control over your own life as a physician, so things like control over the environment you practice in, your own schedule and the way you care for patients.
With this autonomy, I think comes with—it's very protective against burnout. However, there are a lot of non-clinical responsibilities that physicians in private practice have to take on that may not be found in other settings, so things like increased administrative burdens, having to deal with business operations, personnel management and even marketing. So all of these non-clinical duties may contribute to burnout. And so there's a lot of things that are out there that are pro and con for private practice.
Unger: We're going to dig into each one of those things that you outlined. Let's first talk about those operational responsibilities and the way that the practice is run. And there may be—I'll use a technical term—inefficiencies that might be at the root cause of some of those burdens. What does that mean, and what are some of the ways that you've found to address those?
Dr. Chen: So I think inefficiencies in private practice mirror practice as a whole, practice in all settings. However, I think with the typical small size of private practice, these inefficiencies can be amplified, so things like repetitive tasks that we do every day that may not be necessary. So, for example, I think a lot of physicians know this headache of logging into their electronic health record system multiple times an hour or signing things that don't necessarily need a legal signature.
And a lot of us will re-document things that are already in the medical record that may not even have to be done. And so our colleagues in practice transformation, they have a process, which they call GROSS, Get Rid of Stupid Stuff, in which basically there's a process to try to eliminate or at least reduce those inefficiencies.
There's another way of trying to get rid of some inefficiencies in a practice that are mostly physician related. So this concept we call team-based care in which we try to offload some of these tasks that don't require physician attention to other valuable members of the team. And so all of these things or both of these things are really defined in detail in our Private Practice Simple Solutions. That's a webinar series that our group puts out.
Unger: And I'd encourage everybody out there to take a look at that webinar series and learn more about those things, that technical term, Get Rid of the Stupid Stuff, but it does add up to a lot of time over the course of the week. So really important. You mentioned this idea of burdens.
There are many. One of them obviously is paperwork. And there's a lot of it, just the amount and, of course, knowing what does need to be processed or not. What's the advice there on the paperwork side?
Dr. Chen: Well, so there's a lot of paperwork that's out there. The first thing that comes up is, hey, there's a lot of paperwork the patients have to fill out at the front desk, things like HIPAA forms, or consent forms, or even medical history intake forms. Other forms that are necessary for private practice are things like employee intake forms and job descriptions, reimbursements for expenses or even time off forms. And then there's some back end things that are out there as well.
Historically, physicians have had to generate these forms. But more recently, our team has collated some of these forms into a Private Practice Playbook appendix. And it's basically a series of online Word documents that a practice can go and download and tailor to its needs. And they can actually put these into their electronic medical record system or their practice management software or even patient portals. And so there's no need to necessarily reinvent the wheel time and time again.
Unger: So that Private Practice Playbook, again, available on the AMA site. So encourage everybody to take a look at that. That can be a big help there.
Dr. Chen: Absolutely.
Unger: You mentioned another big thing, and we hear this a lot from physicians in private practice is the business side. So not necessarily courses in medical school about running the business side. Last I checked, I did not see one about marketing in there, although I'm eager to talk more about marketing. How do physicians learn more about that business side, about that marketing side?
Dr. Chen: Well, I think there's a lot of resources out there. But specifically, we have resources at the AMA, of course. And our Private Practice Simple Solutions, which I spoke about before, which is a webinar series, has a couple of webinars specifically dedicated to marketing and branding to get your practice's name out into the community so that patients know you and that you can get referrals from other doctors. And so that obviously is extremely important for private practices to thrive.
Unger: And anything else on the quote, "business side" in terms of advice for physicians?
Dr. Chen: Absolutely. I think that wherever you can get ideas, resources, be them in those resources that we talked about or there's also another resource at the AMA that's basically a collection of all of these other resources that we've talked about called STEPS Forward®. There are toolkits. There's playbooks, podcasts, webinars that deal with a lot of these aspects of having to manage a private practice.
But, also, there are other opportunities at the AMA. For instance, the Private Practice Physicians section is a member group within the AMA of doctors that are dedicated to basically making sure that private practice is sustainable and is an option for physicians if they so choose to go into that. That's a great forum for physicians to learn about private practice and to learn from their peers of all sorts of different walks of life and practice settings, locations, et cetera.
Unger: And a big chance to, of course, enact policy through the House of Delegates, of course that will recognize the concerns and some of those obstacles that private practices are facing. I did want to just kind of hit on again you brought up STEPS Forward®. Lots of different modules.
Again, you can find those modules on the AMA site. They're available to all physicians out there. They do everything from how to save hours a week by stopping some of that stupid stuff or some of those repetitive tasks, managing your inbox, emails, all of these things that just chip away at the time that physicians have to spend with their patients.
So, again, STEPS Forward® on the AMA site. Dr. Chen, it's been a pleasure to have you here. Thanks for all the work that you're doing on behalf of private practice physicians and to reduce burnout. Such an important task that we've got ahead of us.
That's it for today's episode. I just want to note that the AMA is also working to reform Medicare payment as part of our many efforts to support private practices. And you can learn more by visiting ama-assn.org/recovery.
We'll be back soon with another episode. And you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.