Issue link: https://beckershealthcare.uberflip.com/i/289185
20 Clinical Integration & ACOs Are We Trading Happy Physicians for Efficient Ones? By Molly Gamble H ealthcare reform is meant to make hospi- tals and physician offices more efficient, but that is proving to have its costs. To say a physician is stressed is like saying water is wet. Physician stress and engagement issues were not born from reform. Take this quote from a surgeon, featured in an article published 10 years ago: "The stress of our jobs is increasing due to the decrease in reimbursement for professional activities, increasing regulatory requirements and severe financial constraints placed upon the hos- pitals in which we must practice." A decade later, those factors remain highly cited for physician engagement issues. But now other factors — such as increased workloads, electronic medical records and physicians' apprehension to work for hospitals — add another layer of com- plexity. Healthcare's pursuit of efficiency seems to be making the adoption of other values it en- dorses, such as patient-centeredness and continu- ity, more difficult. And nobody has a better under- standing of this than physicians. What's up, doc? "A few years ago, doctors used to be in the lounge all the time," says Angela Jones, MD, an OB/GYN practicing at Community Medical Center in Toms River, N.J. She said the lounge was like a revolving door, with physicians coming and going for cof- fee, meetings, meals and rounding. Now when Dr. Jones does spend time in the lounge, it's mostly for indirect patient care, such as placing orders, researching patient history and filling out elec- tronic paperwork. "It speaks to the culture of hospitals now. It's so busy, the relationship between physicians and nurses has very much changed," says Dr. Jones. "It seems like the sense of collegiality — I don't want to say it's not there. But with all the comput- ers and everything being paperless, it seems like there's less need to have real communication. Ev- erything is so automated." Dr. Jones' observations aren't specific to New Jer- sey. Many hospital physician lounges have become spaces for physicians to work rather than con- verse. Some hospitals are even eliminating their lounges all together. "You don't see the camaraderie and discussion that you have seen in the past," says Rochell Pierce, vice president of physician relationship management with Aegis Health Group, a consulting firm. Many American workers are grappling with increased workloads, and there are many occupations in which people do not have time to kick back in a furnished lounge and chat with colleagues. Even if they did, it would likely be seen as a luxury. So why is it such a given in the medical profes- sion? "What's hard for physicians is they are so isolated to begin with," says Liz Ferron, vice president of service delivery at Physician Wellness Services, an organization devoted to improving physician workplaces. "They have so much responsibility on their shoulders, and they are dealing with life and death matters. Many of them don't have a broad support network because they're so busy." The loss of opportunity for physician collegial- ity isn't about physicians having less time to kick their feet up and relax. Rather, it is a testament to how the healthcare industry is inadvertently