Healthcare News of Note: Physician burnout patterns are a potential threat to patient safety, study says

• Improvement in care delivery was rated by both physicians and nurses as more important to their mental health and well-being than interventions directed at improving clinicians’ mental health.
• On average, under single coverage, female employees have approximately $266 more in out-of-pocket spending per year than male employees, excluding pregnancy-related services.
• Only 227 American Indian/Alaska Native students entered U.S. medical schools during the 2021-22 academic year.

Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.

1. Physician burnout rate is increasing and needs ‘immediate solutions,’ says new study

Authors of two published studies reviewing clinician burnout found increased burnout affecting clinician mental and physical health and posing concerns for patient care and safety. One of the studies also looked at which interventions clinicians preferred.

According to the five-year study*of 1,373 physicians at Massachusetts General Physicians Organization, which was published Oct. 6 in JAMA Network Open, the increase in physician burnout poses a “potential threat to the ability of the US health care system to care for patients and thus needs immediate solutions.”

“The burnout rate for 2017 was not statistically different from the 2019 rate,” wrote the authors, adding, “However, compared with 2019, the burnout rate increased significantly in 2021.”

Highest burnout rates

According to the study, significantly higher burnout rates were found among:

• Female physicians compared with male counterparts
• Primary care physicians compared with physicians in other specialties
• Physicians with 10 years of experience or less compared with those more experienced

“Those with less burnout often had more years of experience, suggesting that familiarity with the profession is associated with reduced stress,” the authors wrote. “These physicians also spent less time on administrative tasks, pointing to increased job satisfaction with less bureaucracy.”

* The authors wrote, “The findings may not be generalizable at large because the study was conducted in a single academic medical center in Northeastern US. … The $850 financial incentive [paid to study participants] may bias the survey results, possibly leading to underreporting of burnout and an overly favorable view of physician well-being within the organization.”

Improved care delivery ranked the No. 1 intervention

A second study which included 15,738 nurses and 5,312 physicians practicing in U.S. Magnet hospitals and was published July 7 in JAMA Health Forum, found “high and widespread burnout among clinicians in hospital practice was associated with frequent turnover and patient safety concerns.”

This study’s key findings include:

• Improvement in care delivery rated by both physicians and nurses as more important to their mental health and well-being than interventions directed at improving clinicians’ mental health.
• Clinicians rated improvements in staffing and work environments as more important to their mental health and well-being than clinician wellness and resilience programs.
• 23% of physicians reported that they would leave their current hospital within the year if possible.
• More than 40% of nurses would leave their current hospital.

Other top interventions

According to both nurses and physicians surveyed, some of the best choices out of 21 interventions that hospitals could use to alleviate clinician burnout and help retain staff are:

• Improved nurse staffing (87% of nurses and 45% of physicians)
• Scheduled breaks without interruptions
• Improved team communication
• More control over scheduling
• Additional resources devoted to new-to-practice clinicians
• Reduced clinician time spent on documentation (70% of physicians, just over 50% of nurses)
• Not having to routinely work unscheduled hours (just over 80% of nurses and about 55% of physicians)
• Improved EHR usability

2.  Finding inequity in women’s healthcare costs spurs Deloitte researchers to recommend a review of benefit design coverage

“An intentional review of benefit design coverage with focused analysis of impact on men, women, and individuals of any gender” is recommended by Deloitte researchers after an analysis of health insurance data from the Komodo Healthcare Map revealed women are paying more for healthcare than their male counterparts.

“For employer-sponsored plans, women spend more in health care costs than men on average, but their actuarial value is lower on average and lower for a majority of age bands,” wrote the researchers in the full report (download required). “Women pay more dollars out-of-pocket than men and tend to get less coverage for every premium dollar spent. If solving for only the difference in actuarial value for women covered under employer-sponsored coverage, defined as ages 19 to 64 in this case, the value needed to close this gap is $1.34 billion when excluding maternity claims and applying to the entire working population.”

Although researchers admit $1.34B is a large amount, they say “the fix would likely cost the average employer offering coverage less than $12 per employee per year, or less than $1 per month … by using enhanced products that modify cost sharing for certain services.”

Key findings

Additional findings in the report’s executive summary include:

• Women’s out-of-pocket medical costs are disproportionately higher than men’s for every age grouping from 19 to 64, even when excluding pregnancy-related services.
• On average, under single coverage, female employees have approximately $266 more in out-of-pocket spending per year than male employees (just over 18% more), excluding pregnancy-related services.

“Health care insurers and employers have an opportunity to examine and redesign benefit coverage to help reduce the financial burden placed on women,” wrote the authors. “This can drive equity in organizations and help to achieve optimal health and well-being for women and men alike.”

3. Only 0.4% of physicians in the U.S. identify as American Indian or Alaska Native

The representation of American Indian and Alaska Native (AI/AN) physicians in the U.S. physician workforce is so low it could take “102 years to overcome the deficit” if the current rate of AI/AN matriculation continues, according to authors of a comment published Oct. 8 in The Lancet Regional Health Americas.

“Only 227 AI/AN students entered U.S. medical schools” during the 2021-22 academic year, wrote the authors.

They added, “Only 4,104 (0.4%) active physicians in the U.S. self-identified as AI/AN, according to the 2021 AAMC [Association of American Medical Colleges] State Physician Workforce Report. If AI/AN representation in the physician workforce matched their proportion in the U.S. population, there would be nearly 30,000 AI/AN physicians today. In the absence of transformative efforts to address this health equity crisis, population parity will never be a reality.”

HFMA bonus content

• Read the October issue of hfm magazine, including the Expert Reviewed story “Can MRF data be used for comparative benchmarking?” by Panacea Healthcare’s Fred Stodolak and Govind Goyal; the column “Is consolidation in healthcare the work of modern-day robber barons — or the result of overdue reengineering?” by Susan Dentzer, and the People column “Phoenix Children’s selects Michelle Bruhn as new CFO,” by Crystal Milazzo, senior editor.
• Listen to the recent Voices in Healthcare Finance podcast episode “It starts with mental health: How caring for transgender youth makes for healthier adults,” with host Erika Grotto, senior editor.
• Read the article “Hospitals push back on Senate report that calls out lack of spending on charity care,” by Nick Hut, senior editor.
• Get connected to an interactive online community of HFMA members committed to helping their organizations — and each other — thrive.