In an article, "Healthcare can take a lesson from the airline industry, doctors say,” FierceHealthcare recently covered an opinion piece by Sinsky and Privitera from JAMA which highlights the need to improve the clinical work environment by essentially creating a less cluttered mental landscape for physicians. This isn’t proposing we teach a greater resiliency to putting up with the clutter, but instead addresses the meaningful ways in which we might create better and safer working conditions.
The authors astutely note that other industries that require concentration and rapid adjudication, professions with high cognitive workloads, such as that of airline pilots, are attuned to the need to minimize workplace distractions in order to maximize attention to the task at hand. Decluttering the mental space of the clinician–removing unnecessary alerts, disruptions from repeated logins, form completion that is without clinical value, and burdensome documentation exercises–can go a long way in creating the headspace needed for thoughtful and empathetic clinical judgement.
If we are to address physician burnout, we do need to think beyond the individual physician and confront the work environment itself and the ways in which it contributes to a toxic and hazardous space as Sinsky and Privitera suggest. In addition to removing administrative duties though, to further reduce cognitive burdens, we should also consider ways in which we might ensure that the clinical scenarios themselves are most suited to the physician asked to manage them. In other words, do the types of patients they’re seeing align with their unique training and interests? There is an undeniable frequency of patient-provider mismatches, up to 25% of referrals, that contributes to cognitive overload and frustration. Asking a clinician to address the needs of patients that are not consistent with their area of clinical expertise also creates significant stress and liability for the provider, and contributes to the prevalence of physician disengagement and burnout.
By taking steps to direct patients to the most appropriate care provider, we can better create the atmosphere necessary to provide that care and make meaningful progress in efforts to reverse rising burnout rates. Just as decreasing the administrative interruptions creates a more focused and effective workplace, measures taken to improve the alignment of clinical need with clinical expertise will also positively impact physicians’ work environments and overall satisfaction.