Physician Burnout, Thanks to Obamacare

Debates over health care most often assume that if only we spent more money all would be well. The trendy solution is Medicare for all, a version of the national health services that many European countries offer. As for whether we can afford it, people seem to believe that we can just borrow the money. As for whether it will produce high quality health care, the likelihood is that it will not.

Obamacare was supposed to be a step toward better medical care for all. Among its great innovations was electronic medical records. It made a lot of sense. The behavioral economists love it.  It seemed very high tech. In practice, it was not so good.

A dermatologist described the issue on Newsmax in August, 2017:

Part of the healthcare reform imposed by President Obama was a series of mandates (with associated penalties for lack of compliance) that forced physicians to switch to electronic medical records. This was problematic from a variety of perspectives not the least of which is one is that this may be a violation of free speech (how you record your interaction with a patient should be decided by you and your patients). Instead, physicians and hospitals were forced to pay for the implementation of systems that in many cases were not ready for prime time. The companies that made this software reaped the benefits of this regulatory bonanza while healthcare providers and patients had to sort out the nuances of each interaction. Instead of focusing on the patient history, physicians were forced to focus on recording information mandated by their software. The flavor of each interaction was lost as each person became a series of boxes to check during a visit that became less and less personal.

Now, we discover that physicians are increasingly feeling burned out. They are stressed out and exhausted… thinking about leaving medicine or even contemplating suicide. The New York Post reports on the problem. Few other media outlets have noted this unwanted side-effect of Obamacare:

Doctor burnout is becoming a huge problem, according to new research, which finds that nearly half of all physicians feel completely depleted, to the point where one in seven have contemplated suicide.

The annual Medscape report, released Wednesday, finds that on average, 44 percent of the medical professionals your existence depends on report feeling stressed out to the point where they’ve considered leaving the field altogether.

A higher percentage of these wiped-out life-savers are women, according to the survey of more than 15,000 doctors.

“It’s alarming,” says Brunilda Nazario, lead medical director at WebMD, which owns Medscape. “These numbers haven’t changed, and the problem just continues to be a trend, despite increasing programs to address wellness,” such as “nutrition and exercise programs, or more time off.”

Evidently, a burnt-out physician is an ineffective physician. As for the reason why the situation has become so bad, everyone seems to agree that the culprit is the Obamacare mandate for electronic record keeping:

The reason for the scary numbers isn’t what you would think: Most doctors say it’s the level of paperwork and data input they’ve had to do since medical records went digital. Doctors end up spending about 45 minutes per patient visit on tasks like “inputting data codes for the visit,” Nazario says, leaving little face-to-face time with patients.

“[Doctors] are spending an enormous amount of time taking in data during physician-patient visits,” she says. “I know during my last visit for my physician, I think the doctor spent no more than two minutes looking at me. They were looking at a computer screen.”

More time keeping records means less time with every patient.

The result is scary: “I dread coming to work,” one neurologist says in the report.

A family physician says the stress is taking a toll on her physically: “I’m having recurrent miscarriages.”

“I’m drinking more and have become less active,” an anesthesiologist says.

Though most doctors say the depression doesn’t affect their patient care, 35 percent say they find themselves getting exasperated with their patients, and 14 percent say they make errors they wouldn’t normally make.

So, a seemingly great idea has produced some seriously unintended consequences. Somehow or other the great minds who produced Obamacare did not factor in the time and effort that it would take for physicians to keep up with mandated record keeping.

The Post article explains:

… all the schooling and training they’ve undergone can feel like a waste when most of their day is spent typing codes into their medical software.