Have you noticed that your doctor, dentist or other health care provider is spending less time with you? Are they looking at a monitor more than you, not listening, and writing prescriptions instead?
If not, you are fortunate, since the majority of physicians — 54 percent of 6,880 interviewed in 2014 — experience burnout, and the proportion is steadily worsening.
If you have become increasingly frustrated with health care here in Central Oregon, know that the practice of medicine has become increasingly challenged with more bureaucracy, documentation, insurance hurdles, clerical work, regulations and competition. Know that physicians and dentists commit suicide at twice the rate as comparable, non-physician adults.
One of the primary causes of burnout is the electronic medical records system, which demands that a health care provider spend more time with a computer than with patients. Data input has trumped the provision of the associated health care services it is supposed to reflect. To add insult to injury, the records produced muddy the clinical picture — subsequent readers are challenged to follow the clinical reasoning of the author. Outside the office, clinicians spend another one-to-two hours of personal time each night on non-clinical computer and clerical work.
Another factor is that insurance companies do not negotiate reimbursement rates in good faith. The contracts physicians sign do not specify reimbursement rates. Reimbursement and denial of payment are discovered only after services are rendered.
Underpayment results in seeing as many patients as possible to maintain income and cover overhead, which strongly encourages taking shortcuts resulting in chronic fear and stress of missing something important.
Finally, the contracts dictate that the insurance company has “final medical decision-making authority.” The insurance company views your provider’s treatment plan like a suggestion box, and is legally protected from any subsequent harm from denial of coverage.
But who is suffering and dying? Well, it is actually both patients and their health care providers, including physicians, dentists, physician assistants and nurses. When it comes to the current health care system and health care reform, we must do something. Too many people are suffering and dying, while the economy is being drained.
The solution is an interactive process between patients and providers. One step is a symposium on the topic on Nov.2 and Nov. 3 in Bend at St. Charles Medical Center. The symposium (www.comedsoc.org) is coordinated by the Central Oregon Medical Society and cosponsored by the St. Charles Foundation, Central Oregon Dental Society, Bend Memorial Clinic, High Lakes Healthcare and the Central Oregon Health Council. Mental health and wellness among health care professionals and their families will be evaluated, presented and discussed by 10 experts from around the country. Health care professionals, spouses and other family members are invited. Find out if your doctor, dentist, or provider is planning to attend, and if not, why.
But, what about the patient? This is the main point. What do we expect to happen to patients in an adverse system that induces impairment, burnout and double the suicide rate? It would be safe to say patients are paying dearly.
So, what do we do? The solution ultimately lies with providers and patients working together.
First, providers need to come to a relatively common consensus about the issues faced by all. We need to stop in-fighting. As mentioned above, a tangible first step would be to attend the symposium.
Second, providers need to start communicating with patients about our health care system and that the seemingly disparate, but overlapping problems providers and patients both face are what leads to provider impairment and burnout, also leads to increased suffering and premature death of patients.
Third, patients should be aware of their care providers’ current dilemma — too much documentation and not enough time with patients as a direct result of insurance company limitations and demands. Basically, providers and patients need adequate time to listen, understand, think, communicate and build trust. Given the lives at stake, we should expect nothing less.
— Mike Henderson, DO, lives in Bend.