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How can virtual care fix the health care industrial complex?

Ian Tong, MD
Physician
September 13, 2018
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The health care industry is experiencing a crisis. There’s a shortage of highly skilled doctors. And as a result, doctors are working long hours that are affecting their stress levels, increasing burnout rates, health and the ability to diagnose their patients properly. This piece will discuss the many solutions to this problem: from offering better, more integrative training to doctors, using telemedicine to provide patients with quick, responsive care, and what kinds of incentives medical practices can offer their doctors to increasing retention and providing doctors with the kind of environment that will help them thrive.

Virtual care’s role in fixing the health care industrial complex

The health care industry is experiencing a crisis. Doctors are experiencing record highs of career burnout — 38 percent for men and 48 percent of women respectively. As a physician who went into the profession to help people, build relationships and change lives, I find these numbers disturbing, and I know firsthand what it’s like to work under high levels of stress. After all, 20 percent of doctors and physicians work 60-80 hour weeks, leaving little to no work-life balance.

Health care as it is today is not sustainable. But it doesn’t have to be this way. Leaders in the health care industry can make a difference in the lives of physicians and in their patients by investing in their doctors and ensuring a better quality of life. So what needs to change, and how can medical practices create better environments for doctors to thrive?

The challenges physicians face in providing the best quality of their career

Having worked with some of the most vulnerable populations in my past life as a doctor at a VA clinic, I experienced how working long hours and navigating complex patient relationships negatively impacted my quality of life and my quality of care.

I remember one particular unhoused Veteran whom I suspected was selling the pain medication I was prescribing. Initially, my strategy had been to build trust and gradually taper this veteran over time, but I was informed by other residents at the shelter that this veteran was selling the medications.

As his doctor, I felt angry and betrayed. My first thought was to call the police and alert authorities. My identity as a care provider was challenged and I felt like I had betrayed my values. I had lost compassion for my patients. Fortunately, I had a discussion group that few doctors are granted the time or latitude to enjoy. For four years, I facilitated a rotating group of Stanford medical students where we discussed our insights around successes and failures of patient care we had witnessed in our hospital rounds. I shared the difficulty I was having with my Veteran experience and my students’ thoughtful, honest questions re-oriented me to the caring, empathic and responsible doctor I was working so hard to become.

Unfortunately, for many of my colleagues, they don’t have a group of enthusiastic medical students to fall back on. The reality is that the care environments that many doctors and physicians are currently finding themselves in is creating poor working conditions, not optimal for themselves or their patient’s health.

Providing doctors with the tools to succeed

When we look at what contributes to better doctor performances and improved client outcomes, the results aren’t totally surprising. Work-life balance, mentorship opportunities, access to personal and continued educational development, comprehensive health care benefits, flexible leave policies and paid resources for counseling and health and wellness are top qualities that doctors are looking for in their ideal workplace.

Investing in your physician’s health can be your best investment. It’s one of the guiding principles behind how we hire and treat our physicians at my current workplace, and it’s why we invest so heavily in the integrative health care training of our doctors. We understand that doctors want to build relationships with patients that are therapeutic and efficient. Our training focuses on optimizing the care environment to allow for focused, un-interrupted history gathering that develops trust and better patient and clinician relationships.

Additionally, what I’ve learned in the field and from working with others is that creating a positive working environment is crucial to a doctor’s success. Studies have shown that physician happiness and well-being are directly related to doctor performance, and that doctors that are happier provide better care. Happier doctors are more engaged, better listeners and more resilient.

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Making health care a more inclusive work environment and supportive of women and parents

Today, there are more women entering the medical field than men, yet women only make up 30 percent of physicians across the United States. Meanwhile a study by JAMA Internal Medicine found that not only do the patients of female clinicians have lower mortality rates but lower readmission rates as well.

Where I work, we are committed to increasing the total number of women physicians in health care, and we’re leading the industry in creating a supportive work environment for women. In fact, women currently make up 60 percent of our physician workforce and 70 percent of our physician leadership is comprised of women. We’ve implemented policies to foster an inclusive environment for working moms, which includes the ability to work remotely, have flexible hours and access to mentorship and continued education opportunities.

Those of us who are in leadership positions in the health care industry need to make a commitment to do everything we can to create an environment equally supportive of female and male doctors.

Giving doctors the time and flexibility to control their own schedule through telemedicine

Ninety-two percent of millennial physicians claim that work-life balance is a top priority in their lives. To create this balance, health care providers must offer doctors more flexible schedules and the ability to work remotely. Offering remote care technology like telemedicine helps facilitate this kind of change.

Telemedicine also enables physicians to determine their own hours and schedule. The best-designed telemedicine platforms optimize the time physicians spend seeing their patients and minimize paperwork and other administrative tasks. This not only improves the clinician’s experience, but it also improves the patient experience as they have shorter wait-times and high-quality clinical care.

One of the most crucial steps to addressing physician burnout is improving physicians’ quality of life. In order to best support physicians, the health care industry needs to demonstrate that we value work-life balance, respect that our physicians need the time to take care of their mental health and their families and provide physicians with the technological tools to do their job with minimal paperwork. By doing this, the health care industry not only helps prevent physician burnout but invests in physicians and patients alike and improves everyone’s quality of life.

Ian Tong is an internal medicine physician.

Image credit: Shutterstock.com

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