A blessing or a curse?
Burnout is a growing situation that is slowly undermining the productivity of physicians and their staff. And in recent years, the situation has worsened as patient demands, documentation and regulatory requirements increase.
Added to the situation are the challenges of adding technology, the need to be virtual and meet patients where they are, and the need to keep up with the ever-changing information and landscape in terms of what our patients expect of us.
Kirk Davis, executive director of operations at Dignity Health, calls it time poverty, as demands on doctors increase, calling for more time in the office and less time at home with family, tipping the scales from work-life balance to burnout.
Those who become doctors go into medicine because it gives them meaning and purpose. Yet many feel their altruistic reasons have been squeezed out of the field of medicine, which has become very robotic and documentation-centric as relationships with patients are less emphasized. Add to this the challenges of VURs, which determine reimbursements for services provided, and it’s easy to see how much of the work doctors do seems unrelated to patient care.
I compare the application of technology in medicine to distracted drivers and their cell phones. Cell phones are great, but when behind the wheel drivers need to focus on the road and not texting and doing stupid things that will keep them from being safe.
And I think in many ways our doctors and our staff are distracted clinicians. They have technology that barks at them and tells them to pay attention and watch tasks, alerts, and information. And during the pandemic, we’ve added video visits, forcing doctors to fumble with another layer of technology to interact with patients, but alienating them even further in some ways.
On top of that, add requirements for EHRs (electronic health records) and documentation; no wonder our docs are distracted. More and more clinicians are retiring early, changing professions, reporting burnout and depression, and even committing suicide.
Can technology ease the burden?
The promise of technology in medicine certainly makes sense. We see it in other industries, making it more efficient to book travel, find a restaurant, and figure out where we’re going to eat or buy movie tickets or whatever in our lives which has been made a bit more accessible and easier to do.
And yet, in healthcare, it feels like the promise of technology has yet to deliver. We are a bit behind other industries. Companies were already hosting video teleconferences, but before COVID, virtual tours were only tried on a small scale. The pandemic has forced clinicians to quickly adopt virtual visits. And while virtual visits may not be the solution for all patients, it is a solution for many, as providers and patients use available technology to facilitate the patient-provider contact journey.
Do algorithms replace experience?
On the one hand, technology makes patients safer. Data-driven programs provide predictive modeling, and some doctors use drop-down menus to make decisions. But when do years of training and experience trump algorithms? When data replaces experience, does it make sense at work as physicians lose a sense of the relevance of their training and experience? When does a doctor rely on his training and experience and not the data? We are still trying to figure that out.
But at the end of the day, we’re still dealing with unpredictable humans who may face stressors contributing to their condition that the computer can’t account for.
As humans, we have this unique ability to take a lot of complex data and put it together and find the nuance in it all. And I think computers and technology and automation can do some of the heavy lifting. And when we couple that with our unique humanity, we can arrive at a patient-centered diagnosis for the person sitting across from us versus a generalized response.
The electronic health record
Nowhere has the technology been expanded to meet documentation and regulatory requirements more than the EHR. From dictaphone and transcriptionists to voice to text, from voice to transcription in the EHR, to the use of scribes, we are seeing an increased use of technology to work in the EHR.
Technology has helped clinicians stay on top of charts instead of working late and having piles of incomplete paper charts on their desks.
Patients are also embracing this technology because it improves access, speeds up care and, probably most importantly, makes things more convenient for them. Because all records are just a click away, there is never the risk of a misplaced chart. And a doctor on duty has access to home records.
Technology can support work-life balance.
Technology can make it easier for patients to see their clinicians and feel more comfortable. Technology can help fill staff shortages. And technology can help doctors work at the top of their license and work with patients the way we want. If we integrate the right technology into our daily lives, it becomes a blessing.
In my opinion, technology is our North Star and we must embrace it.
About David Lundquist, MD
In December 2019, Dr. Davin Lundquist joined Augmedix as Medical Director. In this role, Dr. Lundquist drives rapid technology innovation within Augmedix’s product development teams while maintaining clinical excellence and close alignment with the ever-changing US healthcare landscape. Dr. Lundquist’s portfolio includes introducing next-generation natural language processing automation modules into the Augmedix workflow and advancing Augmedix’s real-time support systems prompting physicians to fill the gaps care and other critical quality initiatives. Dr. Lundquist also supports the company’s business efforts as it expands its footprint among major US healthcare systems.