The financial challenges, pandemic, overburdened administrative requirements and burnouts are top of mind for many physicians. Perhaps the global pandemic has created extremes for the physicians — either they are struggling financially or swamped with the patients having coronavirus, and patients are scared to visit the physician’s practice.
Physicians have become the victims of politicians looking to shift blame as the pandemic fallout produces an increased burnout problem for them. They are juggling several hurdles and difficulties, despite their devotion to medical care management. Providers are figuring out new ways to reduce the tension that arises because of problems, like shifting payment models to government mandates while struggling to cope with the situation or coordinating and communicating effectively with patients to alleviate the risk of chronic diseases.
These are daunting challenges, though they also enable providers to take better opportunities for enhancing patient experience by targeting the patients they serve and providing them the better care they need. The challenges vary with how practitioners provide care to individuals. An endurance challenge is designed, respectively, for intensivists, hospital-based doctors and emergency medicine surgeons in a crucial care state for new patients demanding extensive hospitalizations.
Providers are coping with emotional, psychic and physical stress along with drug shortages. Moreover, their ability to become financially strong might decimate because of the mandated pauses or decline in elective surgery. It is absolutely a concern of financial survival for healthcare professionals, essentially in underserved or provincial regions.
Less Time With Patients
Recently, a national survey of physicians (who are practicing) was led by the AOA (American Osteopathic Association) and the AOIA (American Osteopathic Information Association). The intention was to estimate the financial damage which mid-to small-sized practices faced with COVID-19. It showed a 95 percent drop in physician income of the healthcare organizations, and because of COVID-19, about 40 percent of physicians reported they have seen huge cuts in their revenue. One-fourth of them said they will require proactive strategies and additional financial support to manage medical care management.
In addition to this, a survey by the Commonwealth Fund showed nearly 25 percent of primary care physicians in the US have seen inefficient care practices. Physicians mostly used their time for managing administrative tasks, medical billing services and electronic documentation. They spend 27 percent of their average shift with patients, while 50 percent of their day is spent on other ‘’desk work’’ and electronic health records, according to the Annals of Internal Medicine in 2016.
Smart approaches can be beneficial, such as changing your work environment, sharing responsibilities with mid-level staff/providers, streamlining work processes and finding ways to make every second count for practicing medicine efficiently.
You can share the information of your patients in the same hospital with a colleague with ease by using electronic health records, right? But can you share this information using a different EHR system with a provider in another hospital? So, these are the EHR interoperability conundrums. The digital evolutions’ first part involves the federal government that steers physicians to integrate EHR for health record-keeping. However, frameworks have yet to update.
Nowadays, physicians want to hook up with the advanced technology on different platforms by using the latest EHR systems, including synching various sources of medical data to enhance the patient experience, remote patient monitoring, telehealth and more. Luckily, there are many ways for you to make EHRs work and you don’t have to spend time on EHRs alone. Consider the following tips for enhancing the productivity of EHR in 2020:
- Streamline form completion by implementing a mobile document library to save time.
- Consider reworking your office routine so your support staff is your biggest resource.
- Use a solution like mobile medical dictation to avoid typing.
- Give patients access to in-office kiosks and online portals.
- Save your time so they can handle some data entry.
- Work with your partners to streamline data entry by eliminating unnecessary steps and customizing your settings.
- With the right resources, software and systems, you can optimize your clinical workflow — without interrupting patient care.
As a healthcare provider along with medical education, you must stay current with Maintenance of Certification (MOC). It demonstrates that a doctor is continuously educating himself or participating in various activities about medical practice problems like quality/safety and patient care.
MOC involves the four elements;
- Improvement of a medical facility.
- Self-assessment/lifelong learning.
- Professional standing/professionalism.
- Assessment of skills/judgment/knowledge.
Physicians have to face many hassles with MOC. MOC testing, as you know, often burdens physicians with queries unrelated to daily practice, extensive preparation time, annual fees and more. Doctors for assessment and ongoing learning continue to meet the requirements of their medical practice boards during participation in the maintenance of MOC. Though, there is some conflict about those boards that regulate MOC, its cost and relevance to modern practice. Do procedures that are qualified for MOC as its requirements vary by specialty? You must see the particular MOC requirements that you need to maintain your license. These requirements have a significant role as they help you examine the board and check with your specialty which requirements you are meeting thoroughly.
Efforts are underway to maintain the processing of CME (Continuing Medical Education) credits and logging MOC. For that reason, the ABIM (American Board of Internal Medicine) and the ACCME (Accreditation Council for Continuing Medical Education) joined hands. They both worked to integrate the requirements of CME and MOC. Consequently, it utilizes a single framework to submit MOC and CME points to both agencies. Regardless of this, physicians can participate in CME activities approved by the ACCME to receive lifelong learning and self-assessment points for maintenance of certification.
Currently, doctors are at high risk of burnout in the current dynamic healthcare environment. The major cause of burnout is the obliging pace, packed workdays, emotional intensity and time constraints. Burnout suffuses patient care in the form of job attrition and medical mistakes as it is a rampant dilemma. It is referred to as a reaction of chronic pressure because of a lack of sense of individual attainment, emotional fatigue and depersonalization. Practitioners are facing a descending spiral in their mental and physical health by leaving the profession, and this can have dire repercussions.
Studies have shown that in everyday medical practice, more than half of the physicians either indirectly or directly feel the consequences of burnout. For the healthcare community, it is a devastating time. A significant rate of post-traumatic stress, insomnolence, tension and depression has been seen in doctors according to a study. So, they are also losing their family members and colleagues as they have seen unprecedented levels of affliction/losses.
‘’Stress is an antecedent or predictor for burnout. The multiple challenges practitioners are facing leading to excessive burnout, so they are stressed out,’’ Associate Director (General internal medicine division for clinical programs, Minneapolis, Hennepin) and MD Assistant Director for the Office of Professional Work-Life, Elizabeth Goelz, said.
Burned-out physicians often leave practices, thereby decreasing the care continuity and patient access. Additionally, depersonalization leads to poor patient interactions and influences the care quality and safety of patients. There are many things you can do to prevent burnout as a healthcare provider. One solution to decrease your risk of burnout and increase your quality of life instead of increased pay is to opt for time off.
Consistently getting paid is another top-class challenge facing physicians nowadays. However, many doctors take it easy, but only 13 percent of all physicians find it challenging ‘’difficulties getting fair reimbursement.” Accurate coding and documentation can ensure proper reimbursement levels or avoid denials. About 15 percent of E/M services (Evaluation & Management) are paid improperly, according to the CMS (Centers for Medicare & Medicaid Services). Insurance companies reject medical claims for two reasons — insufficient documentation and inaccurate coding.
Physicians can use innovative approaches to avoid E/M claims getting rejected.
- Firstly, you have to be sure you are giving services that are necessary and reasonable. Services need to be justifiable before coding matches with the rendered services.
- Secondly, when selecting E/M codes, remember key variables — the complexity of decision making, place/setting of service, patient type(established/new) and level of provided services based on examination/history.
Furthermore, you can review CMS (Centers for Medicare & Medicaid Services) resources on getting paid for more tips, and don’t forget to obtain signatures of providers.
Negotiating With Payers
Negotiating might not seem like an option, so the challenge of negotiating with payers over the contracts may seem futile. You might feel difficulty not standing to negotiate with payers if you work in a small or solo practice. Often, instead of banging your head against the wall, you accept what they payout. However, that shouldn’t go like this. If you take the right step, you can negotiate for those rates you deserve.
When you counter an offer, think outside the box. For example, if you don’t get the desired pay rates, ask for valuable concessions, like an easier process of prior authorization and an increased period to resubmit the claims. Find out what entices payers after researching them. For instance, if they are eager to decrease hospitalization rates and drop readmission rates, support your commitment against these problems by sharing information with them. Demonstrate a pattern of keeping things low-cost and present positive quality of care data when you show that your practice of medicine is valuable.
In addition to this, you can show off your social media, patient reviews, community presence and tell them how your practice is serving the underserved population efficiently. Figure out your break-even points by analyzing the fee schedules and finances. Walk away if the insurance payers are not meeting this threshold. Negotiate your reimbursement rates by holding insurance payers accountable. An incredibly valuable solution to cope with this challenge is to work with a third-party analyst outside of your practice to seek out an honest, bias-free analysis of your healthcare organization. Accordingly, physicians address a variety of barriers each day, varying from burnout to payment hassles. They knew that their career would be challenging, but perhaps not in the ways they expected while choosing medicine as a profession.