Waiting rooms will be filled but fewer and fewer physicians, nurses and medical assistants will be working to provide quality, efficient care—lasting evidence of the toll on the health care workforce exerted by the COVID-19 pandemic.
Recent health industry research indicates that this situation will continue to escalate with dangerous consequences for access to care—unless physicians are supported in redesigning their private practices. Recent health care workforce statistics from the Kaiser Foundation and McKinsey & Co. indicate a steady loss of physicians and nurses, and the remainder will be suffering from burnout and stress.
About one-third of doctors and nurses intend to reduce work hours in the next 12 months and about 62% say worry and stress from the pandemic has affected their mental health. About 22% of nurses say they may leave their jobs in the coming year, and 69% of health care executives fear nursing shortages are worse than a year ago.
Experts Marie Brown MD, AMA director of practice redesign, and Taylor Johnson, AMA manager of physician practice development, discussed ongoing practice management challenges and potential solutions in a recent webinar, “Navigating the Current Healthcare Landscape: COVID-19, Staffing Crisis, and Administrative Burden.” The webinar is part of the AMA Private Practice Sustainability Project.
Dealing with staff stress and burnout
“The COVID-19 pandemic has created stress and burnout levels in the health care workforce that are so severe that one of five physicians and two of five nurses reported they are moderately likely or higher to leave their current practice in the next two years,” said Johnson, referring to research conducted by Christine A. Sinsky, MD, the AMA’s vice president of professional satisfaction, and colleagues.
What’s driving the diaspora? Stress and burnout from already insufficient staffing levels, ever increasing regulatory burden, along with the emotional toll and the demanding nature of their jobs. Also, a feeling of not being valued by their organizations as the workload continues, Johnson said.
However, despite many systemic challenges, the AMA is working to help doctors respond to these challenges, noted Dr. Brown. A key strategy is to remove day-to-day obstacles to patient care, which allows practices to do more with fewer people and allow time for doctors to get back to spend quality time with their patients.
“There is a tremendous amount of time wasted in our day-to-day work. We can find inefficiencies we can get rid of,” Dr. Brown said. These inefficiencies can cost physicians and the practice staff as much as four hours each day.
Dr. Brown recommended physicians and practice managers start thinking like efficiency experts, targeting ways to reduce their office clerical burden and tame their EHRs, and move toward team-based care to improve workflow.
“Look at what we can do to remove unnecessary tasks such as inbox messages that don’t require the action of the physician including duplicate messages, notifications of tests without results and copied labs ordered by other physicians,” she said. “Look upstream and stop the flow of messages into the inbox, rather than spend time finding staff to help triage and empty the inbox.”
Save 30 working days annually
Dr. Brown pointed to the “AMA STEPS Forward™ Saving Time Playbook” (PDF), as a good guide to improving efficiency and “eliminating stupid stuff’” in the office.
“If you implement just one or two of these practices, you could save an hour a day. An hour a day adds up to over 30 working days per year” for each physician or other health professional in the practice, she said.
The playbook outlines many ways to save time, particularly in record-keeping, notifications and medication management. Read this article to learn more about the “Saving Time Playbook” or watch this promotional video.
“Pre-visit planning and renewing chronic meds for at least 12 months is a huge time saver,” Dr. Brown added.
Physicians can also find resources for improving recruitment and retention of medical assistants, a particularly difficult component of the staffing crisis, in an AMA STEPS Forward toolkit.
Dr. Brown recommended that practice managers encourage office staffers who have been doing medical assistant work to sit for the medical assistant exam and earn their certification.
As physicians strive to continue to provide care to patients and maintain their practices during the ongoing COVID-19 pandemic, the AMA is providing an updated guide to help doctors to keep their practices open.
The guide, initially published in 2020, has been updated to reflect some of the ongoing or chronic issues resulting from the acute effects of the COVID-19 pandemic, including staffing and workplace safety. Download the complete guide (PDF) for best practices, including a detailed pre-visit screening script and frequently asked questions around privacy and confidentiality concerns.
It takes astute clinical judgement as well as a commitment to collaboration and solving challenging problems to succeed in independent settings that are often fluid, and the AMA offers the resources and support physicians need to both start and sustain success in private practice. Find out more about the AMA Private Practice Physicians Section, which seeks to preserve the freedom, independence and integrity of private practice.