How a Value-Based Care Model Helps Reduce Physician Burnout

The rising toll of burnout among doctors has aroused growing alarm among healthcare leaders in recent years. Estimated to impact at nearly half of the physician workforce, burnout has been shown to cause increased rates of sickness, substance abuse, depression, and suicide among doctors. Patients are affected as well, with recent studies demonstrating that physician burnout is associated with increased risk of safety incidents, poorer quality of care, and reduced patient satisfaction.

In October, the National Academy of Medicine (NAM) released an influential consensus study report that outlined actions that should be taken to address physician burnout. “The NAM report on burnout, based on 18 months of intensive study, did a good job of framing the issue,” says Jessica Chen, MD, who serves as the Chief Quality Officer for ChenMed, and also supervises physician education and training.  

The NAM recommendations, Chen says, confirmed the value of key approaches that are already in place to minimize burnout among ChenMed clinicians. “As an organization that is built on delivering value-based healthcare, we have a different model for primary care that many physicians find refreshing,” she says. 

One key element for physicians at ChenMed is the gift of time: Small patient panels ensure that most ChenMed patients see their primary care providers monthly. “Doctors in many settings often complain that they can’t spend enough time with patients. In our clinics, physician see their patients often and can have a bigger impact—which is why they got into medicine in the first place,” she says. 

Surveying some of the goals outlined in the NAM report, Chen notes other ways that ChenMed is already addressing and mitigating factors that lead to physician burnout: 

Creating positive work environments 

A strong focus on team-based care at ChenMed means that doctors can spend more time with patients and less time handling tasks well suited to other members of the team. “With our team-based approach to practicing medicine, we are constantly looking at ways that other team members can support physicians, and our doctors value that collaboration,” says Chen. 

Each doctor works closely with one care promoter, usually a medical assistant, who can handle everything from performing routine screenings to counseling on preventive care. Even the front desk staffers are valuable members of the team. Seeing patients so often, they too can spot changes that demand attention. “A front desk person may say, ‘Mrs. T called and she just doesn’t sound good,’” explains Chen. 

Creating positive learning environments 

Opportunities for professional growth help minimize the odds of burnout and foster clinicians’ well-being, the NAM report states. To foster both learning and community among recently hired physicians, ChenMed has a preceptor program. The program pairs each new physician with a more experienced physician who acts as something of a mentor. “We try to make sure that each doctor makes a strong start,” says Chen.  
ChenMed also holds monthly videoconference meetings for physicians at all 63 of its sites, often to discuss clinical topics and help doctors stay current. 

Reducing administrative burden 

Clinicians suffer when, instead of being able to focus on patient care, they must commit major time and energy to administrative work and charting, which has grown increasingly complex in recent years. “One common complaint that doctors express, in the fee-for-service world, is about all the documentation that they have to do to support payment,” says Chen. 

Operating outside the fee-for-service model, ChenMed has been able to lighten the administrative load on its physicians, in large part by easing their patient caseloads. While primary care doctors in many systems care for 2,300 or more patients, the patient panel at ChenMed is capped at about 400 patients, with significant support provided by physician assistants. “It’s not that our doctors are doing less. They are doing more, for fewer patients,” says Chen.  

Also, ChenMed discourages doctors in the practice from taking work home in the evening.  “That should not be happening,” says Chen. “If it is, we help our doctors find ways to finish their work at work, including individual coaching to identify opportunities that help them work more efficiently.”

A smarter use of technology

The NAM report emphasized the importance of enabling technology solutions so that information technology is well integrated into doctors’ daily workflow and supports them in providing high-quality patient care. ChenMed has its own technical development team. “Our in-house IT team, which includes physicians, designed our electronic health record and our notes platform, so those systems really reflect the way physicians work, the workflow involved in a visit, and our value-based model,” says Chen. 

For example, the ChenMed EHR minimizes pop-ups, which most doctors find very annoying. “We try to make data entry as easy as possible, with as few clicks as possible,” says Chen. Newly hired physicians at ChenMed often report that these custom IT solutions are much more user-friendly than other EHRs and notes platforms, she says. 

Overcoming the stigma of seeking help

Encouraging doctors who need mental health care to obtain that care is critical, given the fact that the suicide rate for physicians in 2019 was about twice that of the general population, according to a Medscape survey that involved more than 15,000 doctors. 
ChenMed’s leaders recognize the importance of this goal for clinicians and in encouraging wellness of all kinds - physical, emotional, and psychological. During one recent monthly videoconference, “we asked our doctors to ask themselves, ‘Am I eating well? Exercising regularly? Managing my stress level?’” say Chen. And later this year, ChenMed will dedicate a one-month focus to wellness, including mental health awareness. 

Changing what needs to and can be changed

Chen points out that while certain factors contributing to burnout are amenable to change, some are not. “A certain amount of paperwork is a necessity,” she says. “But we have to figure out what’s really needed, what’s most important for patient care, and how our doctors can most efficiently do those tasks.”  

At ChenMed, she says, leaders have long taken a “systems” approach to ensure that clinics work in a manner that maximizes well-being for patients and caregivers alike. “I can’t say that we’re immune to physician burnout,” Chen says, “but we make it a big, ongoing push to help physicians avoid feeling overwhelmed. If they are having issues that could lead to burnout, we help them.”

Want to have more time to spend with your patients? ChenMed’s high-touch, value-based model focuses on patient care, not paperwork. Learn more about our available positions.