Leadership and culture
The systemic transformation needed to address clinician burnout
Author and Expert:
Robin Eickhoff, MD
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Optum Health senior medical director, Dr. Robin Eickhoff, on how value-based care offers a way forward in the clinician burnout crisis
As a family medicine physician and senior medical director for WellMed, a division of Optum Health, Dr. Robin Eickhoff, is all too familiar with the effects of burnout. With nearly 63% of physicians reporting signs of burnout, such as emotional exhaustion, at least once per week, Dr. Eickhoff says it’s often a systemic problem that can be addressed through some of the key tenets of value-based care. Of note within Optum Health, our latest provider experience survey in May 2023 shows burnout at 35.6%, down from 36.3% based on last October 2022 survey. This could be said in part due to the value-based approach within our clinical model.
“Clinician burnout is an institutional issue, meaning it’s really the system in which we work that leads to the problem,” said Dr. Eickhoff. “It’s really a normal human reaction to the stressors that we work under. By moving to a value-based care model, some of the main factors that contribute to burnout are addressed with a team-based approach to care, more available resources and a renewed focus on patient outcomes versus volume.”
Dr. Eickhoff says various factors beyond the COVID-19 pandemic have contributed to rising burnout rates among clinicians. Administrative burdens, electronic medical records (EMRs), loss of patient connections, feeling undervalued and lacking resources necessary to provide optimal patient care are all key contributors. In this interview, she details how value-based care addresses some of the top triggers clinicians face today.
How does value-based care restore patient connections
In my experience, I’ve found a value-based care model allows for a deeper connection with patients. As a primary care physician (PCP) in a value-based care model, I’ve had the opportunity to work together with my patients to help get them the holistic care they need.
Value-based care models create and encourage more primary care management and oversight. This enables clinicians to get to know their patients and understand their goals, and even fears, which in turn helps them to be better. PCPs handle more of their care, completely managing diabetes, hypertension, thyroid conditions and many other chronic health conditions that they might not have enough time to manage in a traditional setting.
PCPs in a value-based care model could know everything that’s going on with their patients, including their specialty care. They can then direct this additional care to ensure the patient is in a stable place and that it is consistent with what the patient wants.
We are all different in our day-to-day processes, but I believe most PCPs go into primary care because of the relationships that they develop with their patients and even their families. It’s all about connection which is critical in building individual resilience.
How can systems address administrative burdens and create clinical efficiency?
There are a lot of initiatives out there, but because my practice is part of a larger network that supports value-based care, we could standardize some of our processes that can make the patient encounter more efficient. For instance, there is an initiative going on right now to make EMRs easier for clinicians to use. We are also able to utilize both virtual and in-person scribes, as well as voice recognition software that is subscribed to at the enterprise level. By giving clinicians this time back, they have an opportunity for better work-life integration, as they can focus more time on activities outside of work.
We make a concerted effort to minimize the bureaucracy and administrative burdens on our clinicians and staff. Being part of value-based care allows us more freedom to take actions that alleviate these stressors for our clinicians.
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Are you ready to transition to value-based care?
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How do value-based care models surround clinicians with more resources?
Delivering high-quality care with great outcomes is difficult to achieve alone. Under value-based care models, the patient becomes the responsibility of a comprehensive clinical team. This team-based approach ensures that patients receive holistic care and fosters a sense of belonging and support within the health care system.
For example, when a hospitalist discharges a patient, we have a care manager making sure the patient has a follow-up appointment and someone who calls to go over any prescriptions.
I’ve also seen this play out with mental health. In a value-based care model, there’s an effort around trying to make sure behavioral health and mental health services are available to patients. There’s also more time available to spend with patients to assess if they’re experiencing mental health issues. We can ask deeper questions and have vulnerable conversations that open the door to addressing mental health needs.
What are the consequences of not addressing clinician burnout?
We are already seeing it everywhere. Clinicians are leaving the field and not coming back. The numbers are staggering and call for action. I’m not just referring to practicing clinicians like doctors and Advanced Practice Clinicians (APCs), it’s all health care workers.
Imagine trying to take care of patients without someone to run the lab tests you order, perform the x-rays, or even just go out to the home to provide skilled nursing care? The health care system as we know it wouldn’t be able to respond and react quickly the way we currently can. To address an issue this large, it’s going to take a transformative response—led by leadership.
Value-based care models offer a light at the end of the tunnel. My colleagues and I have experienced the benefits of a system that delivers the structure and support needed to focus on patient outcomes and provide the highest-quality care. With value-based care, we can pave the way towards a brighter, healthier future for both patients and the clinicians who care for them.