Obstacles to providing quality care source of stress for physicians

Obstacles to providing quality patient care, including the use of electronic health records, are a source of stress for doctors, according to recent study results published by the RAND Corporation.

Researchers based their findings on survey information gathered from 30 physician practices in Colorado, North Carolina, Texas, Washington and Wisconsin. Researchers also visited each practice to conduct in-depth interviews with 220 physicians, medical administrators and allied health professionals.

Those surveyed expressed concern that current electronic health record (EHR) technology interferes with face-to-face discussions with patients, requires physicians to spend too much time performing clerical work and degrades the accuracy of medical records by encouraging template-generated notes, according to study results. Researchers also found doctors worry that EHR technology has been more costly than expected and different types of electronic health records are unable to interact with each other, preventing the transmission of patient medical information when it is needed.

Physicians also reported stress from heavy workloads, limitations on time spent with patients, and the cumulative burden of rules and regulations that take time and resources away from patient care.

To reduce physician frustration, medical practices reported employing additional staff members to perform many of the tasks involved in using EHRs, so doctors could limit their interactions with EHRs to activities that truly require physician training.

Providing high-quality patient care was a primary driver of job satisfaction among physicians. Physicians were more satisfied when their practice gave them more autonomy in structuring clinical activities, as well as more control over the pace and content of patient care, according to study results. Physicians in physician-owned practices or partnerships were more likely to be satisfied than those owned by hospitals or corporations.

Although the study did not address recent health reforms, most physicians and practice administrators were uncertain about how health reform would affect physician satisfaction and practice finances. However, researchers found a common response to health reform was for physician practices to seek economic security by growing in size or affiliating with hospitals or larger delivery systems.

“Many things affect physician professional satisfaction, but a common theme is that physicians describe feeling stressed and unhappy when they see barriers preventing them from providing quality care,” Mark Friedberg, MD, MPP with RAND, a non-profit research organization, stated in a press release. “If their perceptions about quality are correct, then solving these problems will be good for both patients and physicians.”

For more information:

Friedberg MW. Factors affecting physician professional satisfaction and their implications for patient care, health systems and health policy. Available at: http://www.rand.org/pubs/research_reports/RR439.html#abstract. Accessed Oct. 9, 2013.

Disclosure: The researchers report no relevant financial disclosures. The survey was sponsored by the American Medical Association.

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