Paging Dr. Feelgood
Physician Well-Being Is the Primary Driver in Attaining the Quadruple Aim
Physician burnout is a growing concern in America that threatens the health and well-being of physicians, their colleagues and patients. Numerous surveys of physicians before the COVID-19 pandemic indicated that 40% – 50% of all physicians experienced burnout symptoms, with significantly higher rates – as high as 79% – for primary care physicians.
The pandemic has placed enormous burdens on the entire healthcare system and has exacerbated the physician burnout issue. More recent surveys indicate that because of the pandemic, nearly 100% of physicians have reported an overall negative impact on their practices.
While an upswing in clinician burnout during a once-a-century global pandemic is no surprise, it’s the baseline level of widespread burnout that is cause for grave concern.
It is becoming increasingly clear to us at Altais – and many across the healthcare industry – that we will never be able to fix our broken healthcare system without building a path to improving physician and clinical staff well-being. It is imperative that we do so quickly.
We have collectively – and deservedly – dubbed healthcare providers “heroes” and “essential” workers for their commitment to confronting this global health crisis. But we must also concede that expecting healthcare providers to perform heroics on a regular basis is not a sustainable model for success.
The origins of the burnout trend predate the pandemic by a good decade or more. It is only when we begin to address those root causes that we can hope to achieve healthcare’s Quadruple Aim.
The Crucial Fourth Aim
Healthcare’s Triple Aim, introduced in 2007, identified three components for improving the U.S. healthcare system. They included: simultaneously achieving enhanced patient experience; improved health outcomes; and a lower cost of care. This framework became the foundation on which the watershed Affordable Care Act (ACA) of 2010 was built.
UCSF’s Dr. Thomas Bodenheimer coined the now-common phrase Quadruple Aim in 2014. He made the case for adding the well-being of the healthcare provider – be they physician, nurse or other clinical caregiver – as a necessary Fourth Aim to the Triple Aim for a successful and sustainable healthcare system.
In broad terms, the ACA increased healthcare accessibility for more Americans. It launched a monumental effort to shift the financial incentives of the entire healthcare system from a fee-for-services model – in which providers were paid for services delivered, regardless of outcomes – to a value-based care model. In this new model, providers are compensated based on health outcomes.
Achieving all of these objectives simultaneously has required and driven significant advancements in how technology is deployed in healthcare. The past decade of healthcare technology development has had both dramatic and – it’s fair to say – uneven impacts on how providers deliver their care. While their aspirations have been laudable, and their promise remains great, such technological tools as electronic medical records (EMRs), reporting and billing systems and other administrative demands are known to have contributed significantly to physician burnout.
The Last Shall be First
Thus, the path to achieving the Triple Aim must begin with the critical Fourth Aim. Elevating a physician’s well-being – while still moving toward the Triple Aim – happens when their practice and systems enable these three essential goals:
- Achieving practice vibrancy. A medical practice is a community and a machine unto itself. At its best, the providers within a practice work together with clear communications and coordination that are supported by systems that allow each individual to perform at their highest level.
- Achieving practice resiliency. Healthcare will remain a complex enterprise for the foreseeable future. Technology platforms that simplify administrative tasks and supply end-to-end functionalities in an integrated package are essential. Those platforms must manage the many patients, care pathways and payment models for the provider as an essential tool for practice resiliency. These systems should do the hard work of integration – not the providers themselves.
- Achieving professional gratification. The practice of medicine is, for many providers, a mission-driven career. They entered it with a drive to do good, to help others and to heal the sick. Arming a medical practice with technology and tools enables a provider to spend most of their time fulfilling that mission. It allows them to spend time focused on their patients and is a critical component to supporting professional gratification.