This article by Ambra Health CEO, Morris Panner, was originally featured on Forbes on May 28, 2019.
Doctors have the highest suicide rates among all professions. Is technology the reason or the answer?
Clinicians have one of the toughest jobs in the world. They are continuously serving an ever-increasing, aging patient population and dealing with a fast-changing regulatory landscape that puts an emphasis on digital transformation in the midst of alarming doctor shortages. Physicians are expected to deliver more with less time, while healthcare-related costs and regulations are increasing demands for documentation and administrative processes.
“Numerous studies reveal that physician burnout — generally defined as a loss of enthusiasm for work, feelings of cynicism and a low sense of personal accomplishment — is a major problem,” says the dean of the University of Michigan Medical School, Marschall S. Runge.
According to a 2018 report from the Physicians Foundation, as many as 78% of those surveyed feel professionally burnt out at least sometimes, which is 4% higher than the 2016 survey. Physicians are also showing suicide rates at twice the level of the general population.
“It is estimated that 300 to 400 doctors take their lives every year,” Dr. Runge adds.
Burnout Has Dire Consequences
Burnout can lead to low job satisfaction, a less than ideal culture in the workplace, increased medical errors and a negative experience for the patient. In addition, burnout can be very expensive. Stanford Medicine estimates that replacement and turnover expenses, as they relate to doctor burnout, amount to nearly $8 million annually. A recent study by a National Task Force shows that the cost of doctor turnover reaches over $17 billion in the United States.
A Growing Recognition Of The Problem
Being a clinician is a stressful occupation. The causes of physician burnout are many and varied. These include heavy outpatient and inpatient rotations, non-clinical administrative tasks related to health records and code-based insurance billings, stress over poor work-life balance, malpractice concerns, loss of autonomy and a “loss of meaning in our work exemplified by the deterioration of the physician-patient relationship.”
Dr. Darrell G. Kirch, president of the Association of American Medical Colleges, noted that there are five “great disruptions” in healthcare that are also causing excess hardship to providers. These include:
The focus on burnout has finally led to the rise of conversations around the well-being of physicians, which rarely happened in the past. Several hospitals and large physician groups have launched initiatives to address this epidemic. Clinicians are now getting access to wellness counselors, yoga, massages, coaching institutes and more. However, these options might quickly get overlooked, as doctors are usually pressed for time.
Technology: A Cause But Also The Solution?
Physicians spend a great deal of time inputting information into electronic health records (EHR) – twice as much time as they typically spend attending to patients. This, combined with a staggering amount of documentation required for insurance coverage, reimbursement, and medical and legal liability (e.g., malpractice), is a major contributor to physician burnout.
These challenges in day-to-day routine operations are presenting themselves as opportunities and giving rise to many large and small players in artificial intelligence (AI). Below are three examples that demonstrate the emerging potential of AI in the role of reducing the physician burnout epidemic:
1. The Role Of AI In Data Management And Day-To-Day Operations
Physicians can put data into databases electronically without the use of a keyboard and can ask for lab results and charts to be displayed automatically with a single voice command. Recently, 3M acquired M*Modal, a provider of AI-based dictation services to physicians. San Francisco-based Lightning Bolt promises to streamline the scheduling of appointments. Cerner Corporation is investing in context-aware EHR with the sole aim of providing information to clinicians at the point of care. For example, as a physician does their rounds in the ward, the doctor’s tablet would display a patient’s EHR depending on which bed was being attended to.
2. The Role Of AI In Decision Support
The AMA finds decision support to be another area where AI shows promising potential for the future. Using AI, physicians can work with confidence that they are making informed, meaningful decisions, which can, in turn, become data points that will influence other clinician’s decisions. IBM is working on an ambitious project called Medical Sieve. It is aiming to build a next-generation cognitive assistant with analytical reasoning capabilities that can assist physicians in the decision making process.
Abiding by regulations doesn’t make life any easier for clinicians. The Protecting Access to Medicare Act (PAMA) requires doctors to review various criteria before they can order imaging services such as MRIs or CTs for their patients with Medicare. The goal here is to reduce the number of exams that might be unnecessary, as well as lower extra health costs. Physicians can explain the information that will be reviewed with patients to show them why an exam may or may not be necessary. Since EHR data entry is time-consuming, the market is responding by introducing automation tools.
Companies like Cranberry Peak, a partner of ours, have developed AI algorithms to act as digital assistants to physicians when they are reviewing appropriate use criteria, which removes a degree of administrative tasks.
3. The Role Of AI In Diagnosis And Treatment
AI-based interactive chatbots can help to onboard patients, analyze responses and provide feedback on their likely health conditions and risks. London-based Babylon invested millions of dollars in an AI chatbot that tries to replicate a doctor’s recommendations with a vast knowledge base and inference engine. The vendor claims that only 15% of its users end up seeing doctors in person. Sense.ly’s “Molly” is another AI-powered bot that helps patients with the day-to-day management of chronic illnesses and post-surgical needs.
Light At The End Of The Tunnel
There is probably never going to be a universal remedy for physician burnout, and AI will never fully replace the essential human touch. High-quality care will always require interpersonal relationships and bonding. As AI makes deeper forays into healthcare, we can certainly expect technology to alleviate the many administrative burdens associated with the profession, thereby ensuring more quality time spent with patients and better outcomes in care.