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EHRs, Red Tape Eroding Physician Job Satisfaction

John Commins, for HealthLeaders Media, October 9, 2013

Problems with electronic health records systems and the overall burden of rules and regulations imposed by payers and other entities are having a deleterious effect on the professional satisfaction of medical doctors, survey results find.

Physicians are most satisfied when they deliver high quality care to their patients, but problems with electronic medical records and red tape are hindering their practices, a multi-state survey shows.

The RAND Corp. report was commissioned by the American Medical Association and surveyed hundreds of physicians in six states to identify the factors that influence professional satisfaction. The survey found that only 20% of physicians said they want to return to paper medical records.

Most physicians, however, expressed deep frustration with costly and overly complicated EHRs that have fallen far short of their promise to improve practice efficiency.

"This is a vexing problem," Mark Friedberg, MD, the study's lead author at RAND, said Tuesday at an AMA teleconference.

"Physicians like some aspects of their EHR and the vast majority prefer EHR to paper. However, physicians also report that EHRs are not nearly as good as they can and should be. The priority, our study suggests, is to rapidly improve EHR usability and functionality."

Friedberg says the survey findings also suggest that dissatisfied physicians "could be seen as canaries in the coal mine for quality as an early indicator of potential problems with quality in the healthcare system."

"Most prior studies have conceptualized physician professional satisfaction as mattering because it may lead downstream to higher quality and better experiences for patients and patient care," he says. "Our findings at least suggest an alternative reason to really care about physician professional satisfaction by reversing the causal and thinking of professional satisfaction as actually an indicator of quality of care rather than something that is necessary for quality of care to occur."

AMA President Ardis Dee Hoven, MD, says the survey suggests that physician satisfaction is a "wind vane that shows us the factors out there that can be barriers to first-rate medical care."

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