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Physician burnout—these characters are to blame

Duke University Health & Medicine News Jan 16, 2019

Physician burnout in the US is reaching epidemic levels, affecting the majority of physicians in some specialties. Practicing medicine is, of course, a stressful job. Make a mistake and you might end someone's life. But physicians are not usually burned out by such life and death matters. Instead, it's the most mundane part of their jobs that's driving them away from the profession.

They're getting burned out one keystroke at a time.

Under the watchful eye of insurance companies and Medicare administrators, physicians are required to spend an increasing amount of their valuable time documenting their care:

  • Proving that a patient deserved to be billed at "level five"
  • Establishing that they have engaged in activities tracked to measure the quality of their care

How big is this documentation burden? Almost half of clinic appointment time these days is spent performing computer-based documentation.

Here is an even simpler measure of this documentation burden—keystrokes. A recent study compared the length of clinic notes in the US vs other developed countries, including Canada, Australia, and Singapore. The study found that clinic notes in other countries were relatively terse. Maybe 1,500 characters, which is about half the length of this essay. But in the US? Clinic notes were more than three times as long!

This is a very solvable problem. We need to reduce documentation burdens among clinicians in the US. If we don't, we will no longer see our best and brightest people practicing medicine.

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