Burnout on the Rise Among Physicians

Half of the general practitioners in the United States are experiencing burnout, according to a recent survey. That is a seven percent increase over 2013.

The burnout rate for primary care physicians is at a level similar to internists, general surgeons and infectious disease specialists, and lower only than critical care and emergency medicine physicians. Physicians in these last two specialtsies report burnout rates slightly above the 50 percent level. In the survey, burnout is defined as a loss of enthusiasm, having a more pessimistic attitude toward the profession, and taking little satisfaction in work.

While these figures are certainly eye-catching, even more striking is the increase in the burnout rate for primary care physicians under the age of 35. In 2013, these younger physicians reported burnout rates of less than 10 percent. By 2015, however, the burnout rate had jumped to more than 40 percent.

The physicians were also asked to rate the severity of their burnout symptoms on a scale of 1 to 7. A 1 indicated that the feeling was negligible and had little effect on the physician’s work and life. A 7, on the other hand, indicated that the burnout was so debilitating that the physician was considering leaving the profession. On that scale, primary care physicians’ average score came out to a 4.17, the eighth highest of all the specialties. Areas with higher scores included nephrology, cardiology, and plastic surgery, which came out between 4.3 and 4.4.

At the low end of the burnout spectrum are dermatologists, psychiatrists, and pathologists, all hovering around the high 30 percent level.

The problem of burnout is a growing concern to healthcare experts because of its effect on patient care, and because it can result in more physicians leaving the practice of medicine. The leading factors that lead to burnout, according to physicians, are such things as too much bureaucratic paperwork, no work-life balance, and too little income.

In fact, the study revealed that income and debt were significant factors leading to physician dissatisfaction. Nearly half of the physicians who reported burnout also complained of having scant savings and high levels of debt, compared to just 33 percent of satisfied physicians reporting similar financial problems.

If you’re a physician looking for new opportunities in 2015, send your resume/CV to the recruiters at Integrity Healthcare.

There are dozens of open positions we’d love to discuss with you. Contact us today.

How to Approach Informed Consent for Patients

When describing a treatment plan to a patient, informing the patient about potential risks is part of what informed consent is all about. Many physicians believe they do a pretty good job of laying out all the potential benefits and drawbacks of a treatment, but there is evidence to suggest they are not doing it as well as they could.

Surveys have shown that physicians are not as conscientious about delving into all of the possible drawbacks of a treatment if they really believe it will help a patient. Although physicians mean well, health experts caution that it is not an advisable course to follow, especially since it could compromise the autonomy of the patient in making an informed decision, as well as the legal ramifications it opens a physician to.

In talking about the potential risks of a treatment, how a physician says it is just as important as what he or she says. The physician needs to adopt a tone of empathy for what the patient is going through. Some medical experts suggest physicians start by asking the patient what they know about the treatment and risks associated with it as a starting point for informing them about the treatment. After the physician has explained the treatment and risk, he needs to make sure the patient understands it all.

Physicians also need to talk to patients about what the patient expects to gain from the treatment, so the physician can address any misapprehensions. Some also recommend saving the risk discussion until after the examination is complete, and the patient has had time to dress.

It is important that the physician take the time to talk with the patient about risks so that the patient has all the information he or she needs to do what he feels is in his own best interest. Some healthcare experts say that physicians need to cover five basic topics – the procedure, possible alternatives, benefits, risks, and complications.

It is impossible to cover all the risks that attend a particular treatment, so some healthcare experts advise the physician to focus on the material risks, which they define as those risks that have the greatest probability of actually occurring, as well as those that are most severe.

If the risks are considered to be more pronounced, a more detailed conversation about them is required, according to the healthcare experts, as well as when the patient has difficulty comprehending what the risks are.

Healthcare experts also recommend physicians record in the medical record what was covered in the informed consent conversation.

If you’re a physician looking for new opportunities in 2014, send your resume/CV to the recruiters at Integrity Healthcare, one of the most well regarded agencies in the field. There are dozens of open positions we’d love to discuss with you. Contact us today.

Dealing with the High Cost of Drugs

It is a problem that physicians encounter from time to time – patients who don’t take their medications as prescribed. Sometimes it could be from carelessness or forgetfulness, but sometimes the reason for not taking medication is a little more serious.

Sometimes it is the high cost of the drugs that prevents patients from getting medications. They simply cannot afford the drugs. Even the price of generic drugs is becoming so high, along with high copayments, that patients who are insured have difficulty affording the drugs.

Moreover, newer drugs coming on the market are among the most expensive. Cancer drugs, for example, can cost more than $100,000 a year.

Often, this problem goes unnoticed by the physician. Doctors are often not aware of the cost of the drugs they prescribe, and patients are reluctant to talk about the issue. Often, patients don’t realize that they cannot afford the drug until they are standing at the pharmacy window, and when they find out the price, they simply walk away.

But medical experts say that physicians need to be more aware of drug costs, and bring up the issue with the patient, to find out if they can afford the medication.

There are also other actions a physicians can take. For example, they can find out what medication assistance resources are available. Drug companies and foundations have established patient assistance programs such as AmeriCares, a drug discount operation, as well as others like NeedyMeds. And there is the government 340B program, which enables certain medical facilities to buy drugs at lower prices.

Another alternative to look at is the choice of drugs. Many times physicians are prescribing the newest, most expensive form of a drug, when there is an older, generic and cheaper version of the same medication, and just as effective.

But physicians need to make more of an effort to stay abreast of generic drug costs because even the price of generics is climbing rapidly. Moreover, there are significant disparities in costs depending on the drug maker and the pharmacy. For that reason also, physicians need to establish relationships with pharmacists who can keep the physicians up to date on drug cost information.

If you’re a physician looking for new opportunities in 2014, send your resume/CV to the recruiters at Integrity Healthcare, one of the most well regarded agencies in the field. There are dozens of open positions we’d love to discuss with you. Contact us today.

Characteristics of Successful Medical Practices

What factors contribute to the success of a medical practice? What makes a medical practice a better performing one?

These were the questions posed recently by the Medical Group Management Association. In looking at these questions, the Association looked at four performance areas and found that successful practices shared certain qualities in each of these areas

One area examined was spending, and the Association found that better performing practices spend less than others. The study found that more successful practices’ spending amounted to only 56 percent of their revenue, as opposed to 70 percent for other practices.

These more efficient practices used better management techniques to continually monitor their operating costs, to compare their costs with healthcare industry averages, and to use accounting tools to aid them in their analysis.

Another area the Association looked at was collection, and they found that more efficient practices were better at collecting fees as well. These practices collected money more quickly and had on average about $11,000 less in bad debt. Less than 10 percent of their accounts receivable were uncollected after 120 days. Management experts say this measure is a good indication of the health of a practice, and efficient practices have procedures set up to collect funds in a timely manner.

Better performing practices were also more productive. They have procedures in place for efficient flow of patients. The study found that one of the key ingredients for productivity was having the right staff.

The more efficient practices also evaluated patient satisfaction. They asked patients about whether they could get appointments when needed, about their visit in general, how well physicians communicated with them, and whether they would recommend the practice to others.

Another study found that the empathy of physicians also improves patient satisfaction and treatment results. According to researchers, empathy is a fundamental element in evidence-based medicine with a high relationship to patient satisfaction and outcomes.

Moreover, the researchers claim that empathy is a quality that can be acquired through practice. Empathy, however, should not be confused with sympathy, which is more of an emotional connection. Empathy involves more of an intellectual understanding of what a patient is going through.

Having a high degree of empathy can lead to better treatment, while having too much sympathy can lead to higher stress levels among doctors.

If you’re a physician looking for new opportunities in 2014, send your resume/CV to the recruiters at Integrity Healthcare, one of the most well regarded agencies in the field. There are dozens of open positions we’d love to discuss with you. Contact us today.

Ownership of Medical Records

Who should own medical records? Some commentary on the subject has appeared recently in the press, and it has elicited some strong opinions on both sides of the issue.

As things stand now, physicians and hospitals have ownership of medical records. But that fact doesn’t appear to be well known among patients or the medical community. According to a recent survey, more than half of patients believe they own their records, while only about 40 percent of physicians and hospitals believe they own the records.

On one side, you have people who argue that the medical record should really belong to the patient. It is the patient who is paying for the visit, procedure, lab test, x-ray or hospital stay, they argue. The record documents the condition of the patient’s body.

For many years, physicians resisted allowing patients to see their records because the doctors were concerned that patients, knowing little about medical terminology, would become agitated by what they read.

But studies have shown that when patients are given access to their records, they experience greater satisfaction with their care.

Some physicians argue for patient ownership because often, they say, primary doctors may not know the results of specialist visits, and so the patient needs to coordinate information. Both physicians and patients should have joint ownership, another physician said, because this provides the transparency needed for the best care.

But other physicians still were not convinced that patients should have unregulated access to records.

Some argue that patients were unlikely to be as careful with the records as healthcare facilities are. The records might be lost, or breaches of privacy would be more likely to occur. And if that happened, these physicians argued, it is possible that the physician might bear some legal responsibility.

Also, other physicians said, if patients owned their records, what is to prevent them from making changes to the record if they don’t like what they see? For example, an alcoholic doesn’t like seeing references to his condition in the chart, and so deletes it.

Still other physicians said that they often include notes to themselves on the charts, things that they observe, things to follow up on. If patients owned their charts, physicians might be less likely to include these types of things because of legal implications.

If you’re a physician looking for new opportunities in 2014, send your resume/CV to the recruiters at Integrity Healthcare, one of the most well regarded agencies in the field. There are dozens of open positions we’d love to discuss with you. Contact us today

4 Things You Can Do to Jumpstart Your 2015 Job Search

If you’ve decided to take your medical career to the next level this year, read below for four things you can do to jumpstart your 2015 job search.

Make sure you know exactly what kind of position you seek.

Have a small meeting with yourself to clarify your goals and what you truly want to accomplish in your career as you move forward. In addition, be very clear what it is you bring to a medical practice or hospital. Knowing what you want and what you can provide an employer will help you focus your efforts and will make it easier for you to be chosen for the position you really want.

Find the names and contact information for the hiring managers at the hospital, facility, clinic, or department you wish to work for.

See if you can get an informational meeting with these individuals to learn about hiring trends within their department, etc.

Make sure you’re organized in your hunt for a new opportunity.

Place all of your job search materials (names and contact info, employer facts, resumes/CVs and cover letters, etc.) in one place you can access quickly and easily. In addition, putting these documents in a cloud storage space gives you access to them at any time and anywhere you might be. You’ll want to place paper documents in a binder for easy access, as well.

Find someone (or several someones) who can help you in your job search.

These could be mentors, but they also could be physician recruiters such as those at Integrity Healthcare. As for mentors, be sure to choose people who will provide you with honest feedback and who will help guide you as you make progress throughout your career. Aim to meet with your mentor regularly and also stay in touch with your recruiter(s). Quarterly touches are good.

As mentioned above, if you’re a physician or other healthcare professional looking to make a move in 2015, don’t hesitate to send your resume/CV to the recruiters at Integrity Healthcare. We have many current openings for positions at hospitals and medical facilities all over the country. Contact us today.

Handling Both Electronic Health Records and Patients

Electronic Health Records (EHR), some physicians like them, others are not so fond of them. They have introduced a new element into the physician-patient relationship.

Some patients are not thrilled about EHRs either. The EHR deprives them of the attention of the physician. The physician has to spend time typing to input patient information, clicking various boxes and navigating various drop down menus. It seems that the doctor is paying more attention to the computer screen than he or she is to the patient.

Some doctors are better than others at maintaining a good bedside manner while also dealing with technology. This has more to do with the physician’s social skills than anything else, according to some medical experts. Those who can handle the computer and a healthy relationship with the patient are physicians who have good social skills to begin with, and had a good doctor-patient relationship even before EHRs Physicians who didn’t have good relations with patients before computers don’t have them after computers.

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Dealing with TV Medical Cures

Doctors hear it all the time – patients who ask them about something they heard on TV. And there is a lot of this type of information to deal with because there is a constant stream of medical claims being made by people on television, some who are doctors, and some who are not.

It can be very frustrating for physicians to help their patients separate fact from fiction in all of the claims that are made on television. But some medical experts say it can also be an opportunity to help educate patients and to get them more interested in and responsible for their own health.

The claims on television may be of a spurious nature. There may be little in the way of evidence to back them up, and this is a big issue for physicians to deal with. But another big problem with these claims is that they are presented as cures for everyone, regardless of their medical history or condition.

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Dealing with Resentment

Physicians naturally encounter many different types of personalities in their work, not just among patients, but among other physicians, hospital administrators, and others. From time to time, you may encounter a person who is somewhat irascible, maybe even combative or surly. They may say or do things that will arouse your ire.

Sometimes it’s difficult to shed the emotion, the feeling of animosity that someone may excite, and it coalesces into resentment. It is something that can linger for a long period of time if we let it. If the object of your resentment is someone you see on a daily basis, each time the memory of the perceived slight or conflict is brought back to mind.

But resentment is an emotion with a particularly corrosive effect. It keeps us stuck in the past, in a permanent bad frame of mind, along with a stressful feeling. We need to throw it off if we are going to perform our best.

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How to Handle an Angry Patient

At one time or another, physicians may have to deal with a patient who is angry or belligerent. People are feeling more stress than ever, and the stress and anxiety may manifest itself as anger.

If you are a physician confronted with such a situation, what is the best way to respond? Here are a few ideas.

1. Look for a simple and quick solution.

Often there is an easy way out. It may simply involve getting the patient what he or she wants. For example, if there is a conflict with a particular staff member, say a nurse, you can simply get another nurse to look after the patient.

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