Physicians

For physicians on the front lines, burnout is a real concern.

Phillip Nones Business, Employment, Social Commentary , , , , , , , , ,

bdoIf you’re like many people, you may have begun to notice some telling changes in the “atmospherics” you encounter in your visits to the doctor’s office.

Perhaps the signs are just subtle, but things seem to be a little more stressed in the office – and a little less comforting for patients.

With the big changes happening in how healthcare services are delivered and how care providers are compensated, perhaps those changes are to be expected.

But a new survey of more than 500 physicians by InCrowd, a Boston-based market intelligence company focusing on the healthcare, pharmaceutical and life sciences fields, points to some unwelcome “collateral damage” that has to be concerning to everyone.

According to the InCrowd research results, three-fourths of the physicians surveyed do not feel that their healthcare facility or practice is doing enough to address the issue of physician burnout.

For the purposes of the research, burnout was defined as “decreased enthusiasm for work, depersonalization, emotional exhaustion, and a low sense of personal accomplishment.”

If three-quarters of the physicians think that too little attention is being paid to burnout issues, that may be one explanation for the changes in the “dynamics” many patients sense when they pay a visit to their doctor.

This doesn’t mean that the majority of physicians feel that they themselves have experienced burnout. But in two particular physician categories – emergency care and primary care – nearly 60% of the physicians surveyed reported that they had personally experienced burnout.

And most of the remaining respondents know other physicians who have experienced the same.

While burnout may be a more extreme condition, for many physicians the average day presents any number of challenges and frustrations. Nearly four in ten respondents reported that they “feel frustrated” by their work at least a few times weekly — or even every day.

dtThe two biggest contributors to this frustration? Time pressures, and working with electronic medical records.

Perhaps the most startling finding from the InCrowd survey is that ~58% of the physician respondents say that they’re either unsure or wouldn’t recommend a career in medicine to a family member or child.

To me, that finding says volumes. When a profession goes from being the object of aspiration to something to be avoided … we really do have a problem.

What’s been your experience at your doctor’s office on recent visits?  Do you sense a degree of tension or stress that’s more than before?  Please share your thoughts with other readers.

The Affordable Care Act: Still unpopular with physicians after all these years.

Phillip Nones Business, Economics, Government, Social Commentary , , , , , , , ,

ACAOne of the predictions we’ve heard about the admittedly controversial Affordable Care Act is that acceptance of it will grow over time, as people become more familiar and comfortable with its provisions.

So far at least, we haven’t seen this happening in the public polling about the law.

And now we’re seeing similar dynamics playing out in the all-important physician community.

In fact, the latest findings are that the ACA is more unpopular than ever, if the results of a new survey of physicians are to be believed.

The survey was conducted in January 2015 by LocumTenens, a physician staffing firm and online job board.

The headline finding must be this:  While ~44% of the survey respondents reported that they had been opposed to the Affordable Care Act legislation prior to its implementation, now ~58% are opposed to it after a year of working under the confines of the law.

R. Shane Jackson, president of LocumTenens, had this to say about the key finding:

“After a year in the trenches trying to help patients understand this legislation, physicians by and large feel the law hasn’t done a lot to help improve healthcare.”

More specifically, Jackson noted,

“Physicians feel the ACA has made serving patients and running their businesses much harder.  A year after implantation – and years after the political debate started – doctors are still passionate about how this law should have been designed, and would still like to see changes made that will make it simpler for their staffs and patients to understand.”

Among the negatives physicians see with the current ACA law are these aspects:

  • Lower reimbursement rates to hospitals and physicians
  • Increased compliance burdens for physician practices
  • Higher patient debt due to high-deductible plans

ACA healcare premium changesAlso faulted are the insurance companies for not doing more to inform newly insured patients about their premiums, deductibles and coverage limits.

It isn’t all poor marks for the ACA, however.  Physicians in the LocumTenens survey do credit the legislation for a number of positive outcomes including:

  • Helping more people gain access to healthcare
  • Expanding coverage to more children and young adults
  • Eliminating coverage denials due to pre-existing health conditions
  • Placing more focus on preventive healthcare measures
  • Decreasing the costs of end-of-life care

So what is the “net-net” on all of this?

Two-thirds of the physician respondents want the ACA law repealed (and three-fourths think it will be, incidentally).  But physicians want it replaced by something else that retains the positive aspects of the ACA while doing away with the negatives.

That’s the same message we’ve been hearing from politicians, too.  So the bigger question is how to unscramble the ACA egg … and whether anything actually better can come out of the effort.

Would anyone care to weigh in with their thoughts and ideas in this never-ending debate?

The Continuing Evolution of Consumer Healthcare Information-Gathering Practices

Phillip Nones Social Commentary, Uncategorized , , , , , , , , , , ,

health informationWith the interminable discussion and disagreement about the (so-called) Affordable Care Act we’ve been having lately, it’s easy to lose sight of some of the other important developments in health care and related behavioral trends.

One of them is how people are evolving in the way they obtain their health information.  A new consumer survey helps provide insights.

The survey, conducted among nearly 1,100 Americans age 18 or older by healthcare communications consulting firms Makovsky Health and Kelton Global, shows that U.S. adults visit a physician three times per year, on average.  That’s not much different from what previous research shows.

At the same time, however, American consumers now spend an average of over 50 hours per year researching health information on the Internet.  And they’re accessing such information all over the place – from health-oriented websites to social media. 

WebMD continues to have pride of place among healthcare online resources:

  • WebMD:  ~53% of adults access during the year
  • Wikipedia:  ~22%
  • Health magazine websites:  ~19%
  • Advocacy group websites:  ~16%
  • YouTube videos:  ~10%
  • Facebook:  ~10%
  • Blogs:  ~10%
  • Pharmaceutical company websites:  ~9%

Because health subject matters can be rather complicated or detailed, one would suspect that most people might do their research using a PC rather than devices with less screen-viewing or printing capabilities.  And this research bears that out:

  • ~83% use PCs the most to find health information online
  • ~11% use tablets the most
  • ~6% use smartphones the most

[However, tablet usage has grown from just 4% in the 2012 survey, while PCs have declined by a similar margin.]

The influence of consumers’ own doctors remains as strong as ever.  When asked what would motivate consumers to visit a pharmaceutical company’s website for information, the survey respondents cited physicians over any other motivational influence:

  • Physicians:  ~42% of respondents would be motivated by this source
  • News articles:  ~33% would be motivated
  • TV advertising:  ~25%
  • Drug discount card:  ~14%
  • Magazine advertising:  ~13%
  • Web/online advertising:  ~11%
  • Newspaper advertising:  ~9%
  • Radio advertising:  ~9%

… All of which leads one to wonder if most of the dollars being spent by pharma companies on radio, TV, magazine and web advertising are simply wasted. 

Really, this type of pharmaceutical advertising would appear to be “spray and pray” … on steroids.

Here’s a final piece of information from the Makovsky/Kelton survey that was quite revealing — perhaps even startling:  With all of the talk about the Affordable Care Act, as of the time of this survey a few months back, one-third of respondents reported that they had never spent any time researching the reforms and how they might affect them. 

… And another third indicated that they had spent less than one hour total researching the topic.

What’s wrong with that picture?

Online healthcare and virtual doctor visits: Are we there yet?

Phillip Nones Uncategorized , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Online Physician ConsultationsThe harsh realities of cost are driving healthcare providers, insurance carriers and government agencies to implement policies designed to encourage consumers to take better control over their own health.

More healthcare plans and programs than ever before are including incentives for making lifestyle changes, undergoing preventive care routines, “do-it-yourself” testing as well as online consultations with physicians.

In this regard, it seems everyone is completely on the bandwagon … except perhaps the consumer.

Why is that the case? One reason might be because of what we’ve trained people to expect in the delivery of healthcare services.

For decades, American consumers weren’t given any meaningful incentives for engaging in preventive care or in making lifestyle adjustments. Several generations of Americans were acclimatized to seek out healthcare services when they needed it – and that was when something was wrong. And the billing for those services was sent directly to the insurance company for payment.

In such an environment, preventive health or cost control was the last thing on people’s minds.

I recall being hospitalized for six days back in the early 1980s, along with being given a battery of medical tests conducted by health specialists of every stripe. I’m sure the invoicing associated with my hospitalization and treatment was astronomical … but I never saw a copy of the bill to really know.

My only out-of-pocket expense for the entire week? Thirty dollars for using the television set in the hospital room.

What was surprising to me, even at the time, was that I was kept in hospitalization far longer than I felt I needed to be – my symptoms of infection were gone after just a day or two. If I had been responsible for paying for even a portion of my hospitalization, I’m sure I would have been talking with anyone I could find about how quickly I could be discharged!

Today of course, people are far more aware of skyrocketing healthcare costs – not to mention their concerns about ever-rising health insurance premiums, higher deductibles, and bigger co-pays. Still, when asked about adopting new ways of interfacing with healthcare providers, American consumers seem somewhat ambivalent about them.

A recent online survey of ~1,000 Americans age 18 and over conducted by marketing and research firm Euro RSCG Worldwide found that only ~42% of respondents are comfortable with the idea of having online consultations in lieu of personal visits with their doctors.

[Men are more receptive to this idea (~58%) than women are (~37%) … but women are the ones more apt to make healthcare decisions for their families.]

On the other hand, here’s an interesting additional insight from the survey: When told that having an online consultation with their physician might result in lower expenses, ~77% of those same respondents reported that they’d be open to trying it.

What about the concept of “do-it-yourself” testing? Close to half of the respondents in the survey (~48%) reported that they’re receptive to the idea of using mobile apps to run their own tests and checkups at home. Checking blood pressure was the most popular DIY test, along with tracking and reporting on symptoms.

Of course, as time moves forward, technology is no longer the big obstacle it once was for turning “virtual visits” and “remote care” into a reality. Instead, it’s consumer attitudes and a willingness to adapt. And to accomplish that, the purveyors of modern healthcare must try to undo several generations of “learned” behavior that’s nearly the polar opposite.

Denise Murtagh, a planning director at Euro RSCG, mentions another factor as well: the doctors themselves. “A lot will depend on how facile physicians are with the technology, and how comfortable they are with it.”

And let’s not forget age demographics, too. The survey underscores that Gen-X and Gen-Y consumers are far more comfortable with the idea of physician remote care (47% – 52% positive) than Baby Boomers and those born earlier are (only 33% – 39% positive).

It looks like we’ll need to give this trend a bit more time to come into full flower.