Paging Dr. Burnout: How to alleviate physician administrative burden and still reach value-based care goals
Prior to the pandemic, physicians were already feeling burned out. Covid-19 has only added to the long hours, reluctance for technology adoption, and administrative burden facing physicians. Further, a recent survey found that nearly two-thirds of doctors also cited their long-standing problem with bureaucracy, and more than one-third pointed to long hours as contributing factors to a lack of work-life balance.
The urgent need for the transition to value-based care from fee-for-service (FFS) only threatens to add to this burden. Health systems seeking to create a (VBC) strategy that has staying power need to ensure that physicians are engaged as part of ongoing VBC transition plans.
Based on my work supporting providers and payers in transitioning to VBC and my work as a practicing physician, I can say one thing with full confidence — any healthcare organization that is not fully engaging physician leadership as part of their VBC planning and strategy will face an uphill battle.
Luckily, engaging and listening to physician leadership early and often can make the VBC transition smoother and less complex over time. Considering an end-to-end strategy for driving physician behavior change is a key part of solving the complexity of VBC. To start, here are three core priorities to consider as they relate to driving physician engagement and adoption of VBC:
A workflow problem, not a technology problem
Today, many providers and payers are asking physicians to take a new VBC-focused approach to documentation without giving them the tools and support to do just that. Electronic health records simply were not built for a value-based care world. They are tools that were originally created to support fee-for-service approaches to care. In order to drive sustainable changes in physician adoption of value-driven care without further burdening them with new documentation responsibilities, physicians need a new set of tools and support structures that arm them with the most important patient insights before the patient visit and also at the point-of-care.
- “Superuser” and the importance of a physician champion Healthcare organizations need to also ensure that they have at least one fully committed physician champion as part of their VBC strategy. A physician champion is a critical team member who can serve as a conduit between administration and physicians on the front lines of care. If they are brought into the transition and understand the process at hand, they can serve as a trusted bullhorn that consistently communicates needed changes — and the reasons behind them — in a way that will more fully resonate with the physician audience. Physician leaders can also help address issues before they become full-blown problems, which is a critical part of strong change management within a healthcare organization.
“Show me the money”: align compensation models
If you want physicians to change, you need to communicate two things to them: 1) the impact this change will have on their patients versus continuing to serve them in FFS models of care, and 2) the amount of money they are leaving on the table by not properly documenting patient encounters to align with VBC. The saying “money talks” is true in healthcare, too — and even more so when we are talking about giving incentives to physicians to change how they approach patient visits and document care. If providers and payers want physicians to change, they need to make both a clear human and a financial case for this pivot.
Aside from engaging physicians, many providers are experiencing VBC success as a result of emphasizing the following: significantly extending care visits; prioritizing at-home care; and focusing on direct relationship building with patients so that they are more receptive to physician coaching.
Too often, we continue to see physicians being left out of critical business discussions that relate to the transition to VBC. As a physician and having served in a variety of clinical and business roles at an array of organizations, I know firsthand that leaving physicians on the sidelines will only cause hardships — especially when it comes to long-term, complex changes like VBC. In order to succeed in value-based care, providers and payers need to ensure physician leadership has a strong voice in decision-making and an ongoing seat at the table.
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