Physician Wellness Programs Are Lipstick On A Pig

Kevin MD
Linda Drozdowicz, MD | Physician | November 17, 2017

Here it comes — another email about “physician wellness,” advertising mindfulness training, an ice cream social, or a volunteer day. As a psychiatrist, I can attest to the importance of tending to one’s own mental and physical health in order to strive for wellness. However, the trend of implementing physician wellness programs throughout the U.S. is nothing more than putting proverbial lipstick on a pig. Or, stated differently, this may amount to a very muted and unintentional form of victim blaming: “If doctors just learned to take better care of themselves, they wouldn’t feel burnt out!”

Physicians in the U.S. are not well. Our chances of suicide are significantly higher than the average person’s. More than half of thousands of U.S. physicians surveyed in a Mayo Clinic Proceedings study reported professional burnout. Burnout is a syndrome characterized by a loss of enthusiasm for work (emotional exhaustion), feelings of cynicism (depersonalization) and a low sense of personal accomplishment. So, it might seem natural to try to help physicians out in some way. But the focus on training physicians to be more “well” in an increasingly difficult and toxic health care system is akin to telling a domestic violence victim to take better care of him- or herself to better tolerate the abuse. That would never happen!

The current health care system abuses physicians. With increasing technology have come electronic health records (EHRs). However, these often-burdensome systems are not built for physician efficiency and rather have turned into medico-legal wonder-tools full of checkboxes and liability-focused jargon. If it is not written in the record, it did not happen. That makes EHR charting an exercise in verbosity and excess that is helpful to lawyers but not to physicians or their patients. A study published in Annals of Internal Medicine and further publicized by Forbes showed that for every hour physicians spend providing direct clinical face time to patients, nearly two additional hours are spent on EHR and desk work within the clinic day. Outside office hours, physicians spend another one to two hours of personal time each night doing additional computer and other clerical work. Add to that: increasing regulations and requirements for documentation and reporting for major health insurance programs; a culture of litigation that encourages frivolous lawsuits; excessive time spent arguing with staff members — many of whom are not even medically trained – at insurance companies about why patients need the medications that they are prescribed (the dreaded “prior authorization”); and hospital systems that measure physicians in terms of production, encouraging unreasonably packed schedules that do a disservice to both physicians and patients.

What you are left with is an epidemic of burnout.

To cure what ails our nation’s physicians, we should not focus on physician wellness programs. That is not to say that these programs are bad — they do good, but they are simply a very small bandage on a large, gaping flesh wound. What we do need is widespread reform of our health care system from multiple angles. Tort reform, a focus on creating effective and efficient EHRs and protecting physicians from overloaded patient schedules would be fine places to start. Haagen-Dazs is nice, but I think most of us would trade the cup of rocky road for a more humane quality of work-life.

Linda Drozdowicz is a psychiatry chief resident.


Thank You Ms Drozdowicz and Kevin MD. 


HT to madinamerica.com

Docs Using EHRs, CPOE Less Satisfied, More Likely To Burn Out

Your Papers! We must have your Papers so we can control you(r information).

fiercehealthcare

by Marla Durben Hirsch |

Jun 28, 2016 2:35pm



Use of electronic health records and computerized physician order entry (CPOE) reduces physician satisfaction and contributes to higher rates of burnout, according to a new study from the Mayo Clinic published in Mayo Clinical Proceedings.

The researchers surveyed 6,560 physicians in active clinical practice nationwide between August and October 2014. Most (84.5 percent) indicated that they used EHRs; 82.5 percent used CPOE. However, the number of physicians unhappy with the systems outweighed those who were happy with them.

Of those who used EHRs, only 36 percent were satisfied or very satisfied with them; 43.7 percent were dissatisfied or very dissatisfied. Of those who used CPOE, 38 percent were satisfied or very satisfied; 41.9 percent were dissatisfied or very dissatisfied.

Physicians who used EHRs and CPOE had higher rates of burnout, whether or not they were satisfied with their systems. Of the physicians who used EHRs, only 36.3 percent agreed or strongly agreed that the systems improved patient care, and only 23 percent believed that they improved efficiency. Only 21.9 percent of physicians using a patient portal believed that the portal increased their efficiency.

Pathologists and pediatricians reported the most satisfaction; ophthalmologists,preventive/occupational medicine doctors and otolaryngologists had the least satisfaction. Younger physicians, in general, were more satisfied with their systems than older ones.

“Although electronic health records, electronic prescribing and computerized physician order entry have been touted as ways to improve quality of care, these tools also create clerical burden, cognitive burden, frequent interruptions and distraction--all of which can contribute to physician burnout,” lead study author Tait Shanafelt, M.D., said. “Burnout has been shown to erode quality of care, increase risk of medical errors, and lead physicians to reduce clinical work hours, suggesting that the net effect of these electronic tools on quality of care for the U.S. healthcare system is less clear.”

To learn more:

- here's the abstract

- check out the announcement

Read More:

Mayo Clinic

Tait Shanafelt

EHR

Physician Satisfaction

Thank You Ms Durben Hirsch and FH.

cognitive burnout? Sounds like an incipient mental illness.


If they're mentally ill or becoming so they have No business having anything to do with other people's health, civil rights, and lives.


Revoke their licenses, drag them in for a 72 hr junk medical show trial, get them diagnosed, lied to, poisoned and set up for life, issue them a Government disability check, and the Rest of us, (it couldn't be You who needs to be pasted with an incurable opinion of an incurable opinion, it's those Other people who you've got to be afraid of) will all be doing just fine, eventually, in the mentally healthy World of Next Tuesday.

Updated: Records For Nearly 10 Million Patients For Sale By Hacker

Let's have another thunderous, standing ovation for Centralizing Authority/Anything.

fiercehealthcare

by Dan Bowman |
Jun 28, 2016 1:12pm

UPDATED: Personal information for close to 10 million people is being sold online by a hacker who stole the information from a health insurance database and three hospitals.

On Tuesday, DeepDotWeb reported that a hacker put health records for 9.3 million patients, stolen from a health insurance database, up for sale on TheRealDeal market for 750 bitcoin ($485,000). The same hacker, two days earlier, put records for roughly 655,000 patients across three hospitals for sale online, according to DeepDotWeb andMotherboard.

According to DeepDotWeb 's report of the hospital hacking incidents:
48,000 records were stolen from a hospital in Farmington, Missouri
397,000 records were stolen from a hospital in Atlanta
210,000 records were stolen from a Central/Midwest-based hospital

Records from the Atlanta hack are being sold for “just over 643 bitcoins”

($411,000), according to Motherboard, while those from the Midwest hospital are available for $205,000. Records from the Missouri incident are being sold for $100,000.

The hacker told Motherboard that $100,000 worth of records have already been sold from the Atlanta hospital, saying that “someone wanted to buy all the Blue Cross Blue Shield insurance records, specifically.”

The records include Social Security and insurance policy numbers, as well as names, birth dates and addresses.

The hacker told the hospitals to expect “a lot more,” via a message in DeepDotWeb.

“Next time an adversary comes to you and offers an opportunity to cover this up and make it go away for a small fee to prevent the leak, take the offer,” the hacker said.

Hospitals typically are encouraged to not meet a hacker’s ransom demands in such situations. Case in point, the Department of Health and Human Services, in conjunction with the Departments of Justice and Homeland security, last week published guidance focusing on ransomware in which they advise organizations to not pay a ransom.

“Paying a ransom does not guarantee an organization will regain access to their data,” the guidance states. “[I]n fact, some individuals or organizations were never provided with decryption keys after having paid a ransom. ... Paying could inadvertently encourage this criminal business model.”

In February, Los Angeles-based Hollywood Presbyterian Medical Center paid hackers roughly $17,000 (40 bitcoins) after a ransomware attack left its networks disabled, a move the organization said was “in the best interest of restoring normal operations.”

To learn more:
- read the DeepDotWeb post on the health insurance database hack
- here's the DeepDotWeb article on the hospital hacks
- read the Motherboard post
- check out the guidance

Read More:
HHS
Cybersecurity
Ransomware

Thank You Mr Bowman and FH.

Real Time Sharing of Records 'Virtual Safety Net' for Patients In California

fiercehealthcare
by Susan D. Hall |
Jun 23, 2016 11:19am

Six East Bay-area hospitals in California plan to share patient records in real-time to create a “virtual safety net” for patients, reports Hospitals & Health Networks.

Participating hospitals are the Alta Bates Summit Medical Center in Oakland and Berkeley, Highland Hospital in Oakland, Sutter Delta Medical Center in Antioch, Eden Medical Center in Castro Valley and San Leandro Hospital.

“We’re trying to use technology and available information to make it so no matter what door a patient walks through in Alameda County, we’re all on the same page,“ Jim Hickman, CEO of Better Health East Bay, Sutter Health’s philanthropic foundation partner in the East Bay, says in the article.

The secure data-sharing platform integrates with each hospital’s electronic health record system and will help care teams understand each patient’s usage patterns and care needs in the community.

It also will help the organizations better treat “super users.” For instance, in the first 60 days online, the two Alta Bates Summit Medical Centers registered 16,119 individual patients, 4,191 of whom had been to the emergency department three or more times in the previous 12 months.

They also discovered that 2,000 of their patients had been treated at Highland Hospital and 1,448 had three or more ED visits in the previous year.

When patients go to the emergency department of any participating hospital, push notifications are sent to their primary care physicians and case managers.

Hospitals are employing a number of tactics for better addressing super users, such as making “house calls” on the homeless and using “navigators” within the ED to redirect patients to behavioral and mental health resources, low-income housing and other needs.

To learn more:
- here's the article

Read More:

Alta Bates Summit Medical Center

EHR
Interoperability

Thank You Ms Hall and FH.

Here's our take on the sharing of patients thoughts and moods by health care organizations/workers.

RICO, The Racketeer Influenced and Corrupt Organizations Act