Physician Well-being a Focal Point for Academy in 2018

January 02, 2018 01:48 pm David Mitchell

Nearly two-thirds of family physicians report at least one element of burnout, and the trend is moving in the wrong direction.

[Physician Health First logo]

That's why the AAFP will continue working throughout the coming year with HHS, private payers, electronic health record (EHR) vendors and certifying boards to seek solutions that address the litany of factors that drive burnout: inadequate payment, administrative burden, undue EHR complexity and lack of interoperability, maintenance of certification hassles, and more.

"Every day we work on systems issues that are causing burnout and decreasing physician satisfaction," said Clif Knight, M.D., the AAFP's senior vice president for education. "Our message is that family physicians are overburdened, and we have to find ways to relieve them from this administrative complexity. We are stuck in a morass of regulations and requirements."

Addressing such complicated issues requires ongoing, long-term advocacy, and the Academy's work in 2018 will build on concrete steps taken in 2017 to provide family physicians with some immediate relief.

During the Family Medicine Experience (FMX) in September, Knight introduced the Academy's Physician Health First initiative. Physician Health First features a web portal that includes free resources to help physicians develop individual practices to address burnout and improve well-being, including content related to physician health, financial tools and practice tips. The site, which also dissects organizational and systemic contributors to burnout and offers suggestions for tackling these larger drivers, provides members free CME and access to the Maslach Burnout Inventory (MBI).

As of Jan. 2, the portal had drawn more than 12,200 visitors, and nearly 2,000 AAFP members had accessed the MBI.

Physician Health First will expand in 2018. New content is being added to the portal each month, and a well-being planner that will launch in the spring is designed to help physicians track their own self-care and professional satisfaction. That tool is expected to launch before the Family Physician Health and Well-being Conference, which is scheduled for April 18-21 in Naples, Fla.

Conference participants will be eligible to earn up to 18 AAFP Prescribed credits. But even more importantly, Knight said, the event will help physicians develop an individualized plan to address their well-being.

"This is different from any conference the Academy has ever been associated with before," he noted, explaining that the event is intended to help physicians develop leadership skills that will allow them to influence their organizations and make well-being a priority, offer practice improvement ideas to increase efficiency, and improve personal resilience.

Physician well-being was a focus of FMX in 2017 with mainstage presentations, CME sessions and workshops. Knight said family physicians can expect more offerings related to well-being at the 2018 FMX, which is scheduled for Oct. 9-13 in New Orleans. In addition, the PDW (Program Directors Workshop) and RPS (Residency Program Solutions) Residency Education Symposium, which is scheduled for March 23-27 in Kansas City, Mo., will feature a physician well-being panel discussion moderated by Knight on March 24.

The AAFP also is one of more than 50 organizations that support the Action Collaborative on Clinician Well-Being and Resilience.(nam.edu) The initiative, which was launched by the National Academy of Medicine, aims to improve understanding of the challenges related to clinician well-being; raise the visibility of clinician stress and burnout; and promote evidence-based, multidisciplinary solutions that will improve patient care by caring for the clinicians who provide that care.

Specifically, the collaborative works to achieve these goals by publishing discussion papers(nam.edu) and other commentary, hosting public meetings and developing support tools for clinicians.

The collaborative expects to launch new resources related to physician well-being this month, according to Knight. Its next public meeting is scheduled for May.

Ultimately, he said, the collaborative plans to develop recommendations that can be leveraged with government health agencies and large health systems.

"The National Academy of Medicine has had success in the past taking on big issues, such as patient safety," said Knight. "We would like to see the same type of success out of this effort, with physician well-being becoming a priority."

The AAFP also will continue to focus on burnout and its drivers in Washington, as it did during a June meeting of the GOP Doctors Caucus. The Academy has already offered important feedback to HHS on the agency's 2018-2022 strategic plan, pointing out the need to address prior authorizations and EHR interoperability.

Notably, the AAFP scored a win for family physicians in December, when the Physician-Focused Payment Model Technical Advisory Committee recommended to HHS that the Academy's Advanced Primary Care Alternative Payment Model be greenlighted for testing. The model, which builds on the existing Comprehensive Primary Care and CPC+ initiatives, moves further from fee-for-service, better supports small and independent practices, and reduces administrative burden in the health care system.

The multipayer model would provide an upfront, per-patient-per-month primary care payment that covers direct evaluation and management services, as well as an upfront population-based payment that covers care coordination and other services outside the exam room. It also would provide quality and cost incentive payments and a fee-for-service component.

Of course, some physicians are escaping the burdens and complexity of the traditional fee-for-service world by opting out and instead turning to direct primary care (DPC). The AAFP will once again be a sponsor of the Direct Primary Care Summit, which is scheduled for July 13-15 in Indianapolis. The Academy also has a member interest group focused on DPC.  

Finally, family physicians can always look to their colleagues who have found success in achieving well-being and resilience. Physicians and medical students share tactics that helped them reclaim professional joy -- including working in nontraditional practice settings, pursuing wellness activities and embracing their faith -- in a series of question and answer articles in the AAFP News Focus on Physician Well-being section.