Patients, pages, paperwork, painful processes, and payments. These are all common challenges faced daily that can cause burnout.
Rates of physician burnout are higher than that of the general population, and the onset of that mental wear and tear typically occurs during residency, according to Jodie Eckleberry-Hunt, PhD, associate director of behavioral medicine in the family medicine residency program at Beaumont Hospital in Sterling Heights, MI, and lead author of An Exploratory Study of Resident Burnout and Wellness.
Implications for burnout include a poorer quality of patient care. Research shows burned-out residents make more medical errors and are more susceptible to drug or alcohol abuse and depression.
Just as burnout takes root during residency, so can healthy behaviors. “It is time for programs to begin preventatively promoting wellness and not just looking for burnout. I think we miss too many opportunities if we just look for what is wrong versus encouraging what is right,” Eckleberry-Hunt says.
Program leaders and faculty need to proactively address burnout by looking at its causes and doing something about the factors they can influence. Eckleberry-Hunt's study asked residents to identify stressors associated with burnout and factors associated with wellness. Of 32 burnout factors, the 12 stressors that correlate the highest with burnout include:
Pessimism
Lack of coping skills for stress
Desire to be perfect
Personal bad habits (e.g. alcohol or recreational drug use)
Little control over schedules
Lack of control over office processes
Poor relationships with colleagues
Lack of time for self care
Difficult and complicated patients
Not enough time in the day
Excessive paperwork
Regret over chosen career
Some of the factors associated with wellness include:
Use of a support group for physicians
Talking about feelings
Feeling like one has a say in the training program and control over one's schedule
Having a plan for the future
Having a supportive work environment
Feeling connected and compassionate toward patients
A message centered on physician well-being needs to come from the top of the organization, culminating in an institution-wide culture of well-being. Plant the seed for this change by creating a hospital-wide definition of wellness that fits with your institution's current culture. Remind physicians that they must be aware of their wellness.
Social support is a critical aspect of this process. Encourage the creation of a physician-only support groups lead by a psychologist on staff, Eckleberry-Hunt suggests. In her residency program, they have a group dedicated to helping physicians remember why they got involved in medicine, during which participants recount their experiences in the field. Foster a supportive environment by creating a graduate medical education-specific wellness program that is dedicated to educating residents on the topic and helping trainees who become burnt out.
Additionally, measure and monitor burnout. There are several burnout inventories available that can help residents or faculty members determine whether they're reaching the edge. Encourage trainees or attending physicians whose surveys suggest they may be burnt out to seek help.
By making wellness a priority, you create a better work environment for all, and ultimately, improve the patient's experience.
Two top administration officials signaled that the White House may be willing to jettison a controversial government-run insurance plan favored by liberals. Health and Human Services Secretary Kathleen Sebelius opened the door to a compromise on a public option, saying it is "not the essential element" of comprehensive reform. White House press secretary Robert Gibbs said that Obama "will be satisfied" if the private insurance market has "choice and competition."
The Department of Health and Human Services is almost certain to take on responsibility for creating the criteria used to decide what health records technologies qualify for billions of dollars in reimbursements to medical offices under a new stimulus program, officials said. The decision represents a restriction of the role played by Certification Commission for Healthcare Information Technology, which until recently had served as the government's gatekeeper for endorsing systems designed to improve the sharing of medical records.
The Miami operator of 11 shell corporations that billed Medicare for $123 million in bogus durable medical equipment claims has pleaded guilty to Medicare fraud in federal court.
According to the documents attached to the plea, Guerra owned 11 corporations that purported to supply DME to Medicare beneficiaries. He used straw owners to disguise his control over the companies and submitted approximately $123 million in fraudulent claims to Medicare for DME that had not been ordered by a physician nor delivered to a Medicare beneficiary. Based on those claims, Medicare paid Guerra’s DME companies $35 million.
Federal prosecutors have long acknowledged that Miami and South Florida are a Medicare fraud hotbed.
In March 2007, the Department of Justice established a Medicare fraud strike force in Southern Florida that has filed about 100 indictments charging more than 170 people with fraud. However, there is also concern that the fraudsters are migrating to other parts of Florida and the country as investigations intensify in South Florida.
In May, U.S. Attorney Eric Holder said that during the first year of strike force operations in Miami, the federal government estimated that billing for durable medical equipment fell by $1.75 billion in claims and $334 million in payments.
Interest groups on all sides of the healthcare reform debate have spent more than $57 million on television advertisements in six months, most of it in the last 45 days, said Evan Tracey, chief operating officer of the Campaign Media Analysis Group, which tracks television advertisements. Supporters of President Obama's plan to overhaul the system have outspent opponents, with $24 million worth of advertising, compared with $9 million from opponents. An additional $24 million has been broadly spent in support of overhauling the system without backing a specific plan.
As Congress debates a national healthcare overhaul, state experiments like Tennessee's are informing the discussion. As originally envisioned, the Tennessee plan expanded Medicaid to cover people who couldn't afford insurance or who had been denied coverage by an insurance company. Unlike Massachusetts's more recent universal coverage law, the TennCare plan is most often cited by opponents. They say TennCare's runaway costs show that the public health-insurance proposal by House Democrats could bankrupt the federal government.