Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label EMR. Show all posts
Showing posts with label EMR. Show all posts

Monday, February 24, 2020

Physician Burnout Is Widespread, Especially Among Those in Midcareer

Brianna Abbott
The Wall Street Journal
Originally posted 15 Jan 20

Burnout is particularly pervasive among health-care workers, such as physicians or nurses, researchers say. Risk for burnout among physicians is significantly greater than that of general U.S. working adults, and physicians also report being less satisfied with their work-life balance, according to a 2019 study published in Mayo Clinic Proceedings.

Overall, 42% of the physicians in the new survey, across 29 specialties, reported feeling some sense of burnout, down slightly from 46% in 2015.

The report, published on Wednesday by medical-information platform Medscape, breaks down the generational differences in burnout and how doctors cope with the symptoms that are widespread throughout the profession.

“There are a lot more similarities than differences, and what that highlights is that burnout in medicine right now is really an entire-profession problem,” said Colin West, a professor of medicine at the Mayo Clinic who researches physician well-being. “There’s really no age group, career stage, gender or specialty that’s immune from these issues.”

In recent years, hospitals, health systems and advocacy groups have tried to curb the problem by starting wellness programs, hiring chief wellness officers or attempting to reduce administrative tasks for nurses and physicians.

Still, high rates of burnout persist among the medical community, from medical-school students to seasoned professionals, and more than two-thirds of all physicians surveyed in the Medscape report said that burnout had an impact on their personal relationships.

Nearly one in five physicians also reported that they are depressed, with the highest rate, 18%, reported by Gen Xers.

The info is here.

Thursday, October 3, 2019

Empathy in the Age of the EMR

Danielle Ofri
The Lancet

Here is an excerpt:

Keeping the doctor-patient connection from eroding in the age of the EMR is an uphill battle. We all know that the eye contact that Fildes depicts is a critical ingredient for communication and connection, but when the computer screen is so demanding of focus that the patient becomes a distraction, even an impediment—this is hopelessly elusive.

Recently, I was battling the EMR during a visit with a patient who had particularly complicated medical conditions. We hadn’t seen each other in more than a year, so there was much to catch up on. Each time she raised an issue, I turned to the computer to complete the requisite documentation for that concern. In that pause, however, my patient intuited a natural turn of conversation. Thinking that it was now her turn to talk, she would bring up the next thing on her mind. But of course I wasn’t finished with the last thing, so I would say, “Would you mind holding that thought for a second? I just need to finish this one thing…”

I’d turn back to the computer and fall silent to finish documenting. After a polite minute, she would apparently sense that it was again her turn in the conversation and thus begin her next thought. I was torn because I didn’t want to stop her in her tracks, but we’ve been so admonished about the risks inherent in distracted multitasking that I wanted to focus fully on the thought I was entering into the computer. I know it’s rude to cut someone off, but preserving a clinical train of thought is crucial for avoiding medical error.

The info is here.

Wednesday, November 14, 2018

Keeping Human Stories at the Center of Health Care

M. Bridget Duffy
Harvard Business Review
Originally published October 8, 2018

Here is an excerpt:

A mentor told me early in my career that only 20% of healing involves the high-tech stuff. The remaining 80%, he said, is about the relationships we build with patients, the physical environments we create, and the resources we provide that enable patients to tap into whatever they need for spiritual sustenance. The longer I work in health care, the more I realize just how right he was.

How do we get back to the 80-20 rule? By placing the well-being of patients and care teams at the top of the list for every initiative we undertake and every technology we introduce. Rather than just introducing technology with no thought as to its impact on clinicians — as happened with many rollouts of electronic medical records (EMRs) — we need to establish a way to quantifiably measure whether a new technology actually improves a clinician’s workday and ability to deliver care or simply creates hassles and inefficiency. Let’s develop an up-front “technology ROI” that measures workflow impact, inefficiency, hassle and impact on physician and nurse well-being.

The National Taskforce for Humanity in Healthcare, of which I am a founding member, is piloting a system of metrics for well-being developed by J. Bryan Sexton of Duke University Medical Center. Instead of measuring burnout or how broken health care people are, Dr. Sexton’s metrics focus on emotional thriving and emotional resilience. (The former are how strongly people agree or disagree to these statements: “I have a chance to use my strengths every day at work,” “I feel like I am thriving at my job,” “I feel like I am making a meaningful difference at my job,” and “I often have something that I am very looking forward to at my job.”

The info is here.