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‘Pajama Time’: Unraveling The ‘Whys’ Behind Physician Burnout

Forbes Technology Council

Eric is President of Suki and seasoned technology executive with expertise co-founding and scaling companies including Hotwire and Expedia.

Achieving peak performance is important for any activity or profession, but is especially critical in medicine. High-quality physician care has a big impact on our ability to maintain or return to a healthy life, while clinical lapses in treatment can lead to frustrating or even catastrophic outcomes. While U.S. healthcare is a massive $4.1 trillion-dollar industry serving over 330 million Americans through 22 million healthcare professionals, its success or failure often hinges on a small cadre of only 1 million doctors. In very few industries does so much rely on so few.

Empowering doctors to perform at their best, however, is a complicated proposition. From Covid-19 and increasing clinical demands to incessant questions from internet-educated patients, doctors have to adeptly navigate a medical minefield with the acuity of a chess champion, the hands of a concert violinist, the patience of a monk, the communication skills of a diplomat and the endurance of a marathoner. Then, when the last patient visit is complete, the dreaded night shift of patient documentation begins, leaving precious little time for recovery, let alone any personal or family time.

Physician Burnout Everywhere

Given the current state of clinical care, it is not surprising that doctors are burned out like never before. Almost 40% of U.S. physicians exhibited at least one symptom of burnout in 2020, and another 40% say they are too swamped with work to even seek help. High levels of exhaustion and burnout are especially concerning when considering that doctors, by nature, pride themselves on their fortitude, as simply becoming a doctor requires navigating a gauntlet of demanding collegiate classes, medical school, residencies and fellowships. If almost half of doctors are throwing up their hands and exclaiming enough is enough, that probably is a big reason why 70% of physicians aren’t recommending their profession to their own kids, which in turn makes it harder to solve our projected 38,000 to 124,000 doctor shortage in the U.S. over the next decade.

Burnout Solutions

Thankfully, more and more leaders in the healthcare industry are aware of burnout and are taking steps to address it. The American College of Emergency Physicians recently called for healthcare organizations to promote clinician “wellness,” while the American Medical Association has developed tools to help physicians measure and monitor burnout symptoms. Additionally, more attention is now being paid to how physicians spend their time during a typical grueling workday.

Another solution to burnout is to look broadly at where physicians spend their time and find ways to reduce workload in a way that doesn't negatively impact patient care. Amazingly, doctors now spend twice as much time on non-clinical tasks as they do looking after patients. Administrative burdens such as documenting patient visits, completing billing templates and dealing with insurance companies have become so severe that doctors refer to the practice as late-night “pajama time.” Even more frustrating for doctors is their lack of compensation for administrative tasks, which are now considered part of the job when nothing in their decades of training prepares them for what they spend two-thirds of their professional time doing.

Although doctors’ clinical education typically doesn’t include formal training on handling administrative responsibilities, new technology-based solutions have made significant strides in making these kinds of tasks much simpler and more intuitive.

From a user experience design perspective, building successful physician-centric solutions means eliminating clutter that complicates documentation tasks, as well as creating experiences that mimic how doctors naturally interact with other clinicians and support staff. For the core product experience, improvements in speech recognition and natural language processing are also helping doctors become more productive. Workflow improvements, particularly on mobile platforms, are also having an immediate impact on physician satisfaction by untethering them from desktop computers.

One final way to reduce doctors’ administrative burdens is to improve the broader platform—or electronic health record (EHR)—that acts as their health system interface. Swapping out an old and outdated legacy EHR for an updated one can improve productivity and doctor satisfaction, while making an investment to streamline a modern EHR can also save clinicians time.

Closing Thoughts

While greater awareness and improved technology represent reasons for optimism, more needs to be done, including the possibility of more regulatory action. Airline pilots, for example, adhere to mandatory rest periods and are also in a profession in which on-the-job performance carries large consequences. Time and rest requirements could also act as an additional incentive to reevaluate what doctors spend their time doing, which would allow physicians to focus on what they are trained to do, which is taking care of patients.


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