How telemedicine can leverage the shrinking number of physicians

Photo: Marlene McDermott

Physicians are burning out and leaving the front lines of healthcare in big numbers. The pandemic has aggravated this problem. Solutions to this critical problem are needed.

Clinicians and other experts at telehealth technology and services companies across the country are raising their hands, saying they could be at least one part of the solution to physician burnout.

Marlene McDermott is senior director of therapy services at telepsychiatry provider Array Behavioral Care and a licensed therapist. She has been in behavioral health for more than 20 years.

She contends that telehealth could partially be healthcare’s answer to helping alleviate burnout and staffing struggles, but cautions that resources and support are needed – so the industry doesn't just create a new burnout cycle for clinicians.

We interviewed McDermott to talk about these issues, how to support clinicians in a telehealth environment and what real engagement looks like for clinicians.

Q. Physician burnout is a problem well known in the healthcare industry today. How can telemedicine be used to combat it?

A. By now, we’ve all heard about the reports of the dwindling population in the healthcare industry, and many are seeing it in real time in the world around them.

The staffing numbers are going down, but the healthcare need continues to rise. Telemedicine gives us the opportunity to reimagine how we leverage this finite number of resources to the fullest potential, while also acknowledging that to keep the number of existing providers we have to keep them happy and mentally healthy.

Burnout costs the U.S. $4.6 billion annually. Telehealth could help decrease that financial impact by reducing physician burnout as we’re experiencing it now through investment in solutions that reinvent how healthcare is delivered.

These solutions have the potential to help with the work-life balance struggles physicians experience. Virtual care, which has been leaned on heavily throughout the pandemic, can create greater flexibility and bring more balance back to physicians’ lives.

A huge reason so many are leaving the field behind is because of the lack of focus on the physician experience and the burdensome amount of administrative work that is expected of them. The worst part is that so much of that administrative work keeps physicians away from seeing patients and the ability to operate at the top of their license.

No one goes to medical school to click checkboxes all day. Seeing patients via telemedicine allows physicians to see more patients, increasing access to necessary services and allowing more opportunities to complete documentation in real time.

Q. What resources and support are needed so telemedicine does not create a new burnout cycle for physicians?

A. The telehealth boom during the pandemic has resulted in new technology providers and resources that help patients get care when and where they need it. What has not kept up with this adoption is strategies and awareness around the potential for telehealth to be the new reason providers feel burnt out and leave healthcare.

I’m sure everyone has heard of the burnout healthcare is suffering from whether they work in healthcare or not. What’s different about telehealth is that now colleagues and companies may not see or recognize symptoms of stress or pressure because they may not physically see you around the office or doing your rounds.

Leaders must recognize that now we need to go beyond just looking for in-person clues and be intentional about efforts to recognize and put safeguards in place to stymie burnout.

Being intentional is the key to connection in a virtual setting. Connections are not the same through things like instant messaging and emails. Since you have less time for watercooler talk, you need to schedule time to make connections to better understand the team and how they’re doing personally and professionally.

At my company, we have worked hard to create a peer-driven community that supports clinicians and fosters a collaborative environment, so no one feels alone when doing their job. This takes shape as committees, peer-to-peer and mentorship opportunities, affinity groups, physical health initiatives, and other opportunities.

Something that works well for us is having virtual office hours designated for “pop-in” conversations. When a member at the practice has a question or would like to discuss a treatment plan, I designate a block of hours to be available to connect and be a resource for them.

After I’ve assisted them with a task, I make sure to use the time to check in with them, ask what’s going on in their life and look for ways to recognize how I can help make their work more fulfilling and enjoyable. We’re seeing positive results on clinician wellness so far: 77% of our clinicians believe Array provides adequate burnout support.

To ease the administrative responsibilities of our clinicians, they all are fully supported by an administrative, clinical, regulatory and 24/7 technology team so they can focus on their expertise and provide high-quality care. We also have a large team of care navigators who assist patients with scheduling, records requests, communication with outside clinicians, etc.

We have another team devoted to checking in with clinicians weekly about their schedule, time management and overall happiness. We also have a team devoted to managing the billing, often a private practitioner’s worst nightmare. A dashboard is offered for immediate awareness of administrative and clinical performance.

I also encourage our team members to build in small routines throughout their day around self-care. So many of us that work from home have lost the commute home from work we’ve been used to for years. While most of us don’t miss commuting or formal business attire, there’s a real mindset change that occurs when you go immediately from work to home.

It starts to blur those very necessary work-life boundaries. This can change the feeling you have of being home and not at work. I’ve found it helpful to create a new post-work commute where I walk around the block after work. It gives me time to clear my head, process my day and reenter my home with a different mindset.

Q. What, in your opinion, does engagement really look like for physicians?

A. Authentic engagement is certainly not the $5 gift cards and protein bars I’m seeing on social media. To engage with physicians, you need to consider what they interact with during their work and how you can show them that you appreciate them.

There’s been some interesting research published in the last few years that’s completed a concept analysis of physician engagement.

While not a single health system has determined how to define or measure it, physician engagement has been widely looked at in a cause-and-effect way: Physicians who feel more engaged will mean improvements in work and patient outcomes.

What I took away from this analysis is that in the absence of any physician engagement model – and empirical research in the area – has meant there’s so much more important work to be done.

In my mind, physician engagement should start intentionally and tactically at the organizational level through clear communication, accountability and creating an environment for building strong interpersonal relationships. This is even more true in a virtual care setting.

For telehealth, this can look like a survey to determine what pain points physicians might be having and then make changes that positively impact their friction points. For example, with telepsychiatry, physicians want to document in real time while seeing a patient.

When you’re seeing a patient in person, you don’t get that chance to electronically document while the patient is talking because you want to be engaged and focused on them in the room. With telehealth, you can fully engage with them and document simultaneously, helping reduce the administrative burden and saving our team a lot of time.

At Array, we recognize professional development opportunities are an additional way to support and engage our clinicians. We offer hundreds of courses for continuing education training through our learning management system, provide personal clinician success managers, and schedule individual meetings with senior leadership.

I’ll always recommend bringing virtual teammates together physically for annual meetings or more frequently if time allows. Seeing people via Zoom has become the new normal, but connecting in person with a colleague is still a great way to build camaraderie.

This involvement piece, combined with the previous examples, is essential to fostering a healthier work environment and getting a pulse on how your physicians are doing and feeling. When in doubt on what engagement should look like from your team, ask them. How healthcare organizations prioritize the “people work” is just as important as the clinical work with patients.

Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a HIMSS Media publication.

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