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    Burnout: How can it be prevented?


    What are some solutions to urologist burnout?

    It’s going to take solutions on a lot of levels. This is a national issue. I don’t want to overuse the word “crisis,” but I think it will become a crisis if it’s not addressed in the near future if for no other reason than the work force problem in medicine. It’s estimated we’ll need 90,000 new physicians in the next 10 years. If our ranks are burned out, not performing to their fullest ability, and leaving the work force early, that is going to have implications.

    Also see: Urologists show low adherence to value-based care pathway

    Governmental regulations interfere with our ability to care for patients, and there are steps the government could take to streamline the process of documentation and regulations and so forth. Those requirements have only been additive or even exponentially grown over the years. There are difficulties in getting paid in terms of coding and billing. I think they are intentionally difficult and a burden to us.

    The American Board of Medical Specialties can streamline maintenance of certification. Also, can we use EHRs in a more effective way rather than them being a clerical burden for us? What are the ways we could use them to help our practices? State boards can play a role. Many state boards function in almost a punitive way for physicians, which I think may limit admitting a mental health condition or depression; it needs to be much more private and supportive.

    Our institutions play a very, very important role in this. They have long prioritized patient satisfaction and staff satisfaction—very appropriately—but I think there’s been a blind spot to provider satisfaction. A few institutions have taken leads on it, but just as we use patient satisfaction and staff satisfaction as quality measures for how a hospital performs, I think provider satisfaction should be added to that. People call it the “fourth aim” in medicine. As it becomes a priority for the institution then, accordingly, you can allocate the appropriate resources. If patient satisfaction is low, the institution will dedicate financial and other resources to try to improve that. The same could be done for provider satisfaction as well.

    Speaking for my own institution, the health care system leadership has to meet their hospital metrics and they get incentivized to do that. If provider satisfaction was part of that, I think they may have some different views on where resources should go and how that should be carried out. It may not even be on their radar, to be honest. If it’s not measured, it doesn’t exist, and people can’t do something about it.

    Read: First national urology-wide registry gathers steam

    As more and more of us are becoming part of larger organizations, it goes a long way to have physicians in the trenches involved in participatory management and be a part of the process. Sometimes we feel like there’s a disconnect and that’s a cause of dissatisfaction as well. Ultimately, it falls upon us as physicians to address burnout, discuss it, and develop interventions.

    Next: The role of "20% time"

    Stephen Y. Nakada, MD
    Stephen Y. Nakada, MD, a Urology Times editorial consultant, is professor and chairman of urology at the University of Wisconsin, Madison.


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