
Reducing physician burden starts with four key changes.
Fam Pract Manag. 2023;30(3):21-25
Author disclosure: no relevant financial relationships.

Burnout rates among physicians continue to rise. In the 2023 Medscape Physician Burnout and Depression Report, 57% of family medicine physicians reported feeling burnt out — up 10 percentage points in five years.1 Among all specialties, 53% of physicians reported burnout. The top contributor was “too many bureaucratic tasks,” such as paperwork and charting requirements. Too many working hours and the increasing computerization of practice were also cited as key causes.
A prior study helped quantify this burden. It showed that family physicians spent an average of 5.9 hours of an 11.4-hour workday in the electronic health record (EHR), with an average of nearly 90 minutes of “pajama time” (work outside of normal working hours) per day.2
Recently, the U.S. Surgeon General called on health systems, insurers, government agencies, and others to implement system-level changes to address health worker burnout.3 But many of us are looking for more immediate ways to alleviate this burden. To address this need in my practice, part of my time is dedicated to working one-on-one with primary care physicians and advanced practice providers to find meaningful ways to improve clinical workflows and optimize use of the EHR to decrease their pajama time and reduce burnout. We cannot fix everything, so we focus on what we can control. This article shares the top four tips that work for us again and again, and some lessons we've learned about the process.
KEY POINTS
Top contributors to physician burnout are “too many bureaucratic tasks,” such as paperwork and charting requirements, too many working hours, and the increasing computerization of practice.
While system-level changes are needed, physicians can take immediate steps to alleviate their burden, such as delegating key tasks to other team members and practicing lean documentation.
Implementing change can be difficult and team efficiency may decrease in the short term, but investing in the present will pay off in the future.
DELEGATE, DELEGATE, DELEGATE
A recent simulation study showed that primary care physicians would need to work 27 hours per day to meet current guidelines for preventive, chronic disease, and acute care for their patient panels.4 No wonder we feel overwhelmed. The study found that team-based care decreased this time commitment by more than half, which results in a workload that is still not doable but is moving in the right direction. Decreasing physician burden requires that team members help share the load. We've found that there is no one-size-fits-all strategy for this, even for practices employed by the same health system. You need to assess the staff and resources you have and what you can reliably delegate to others, who must be working at the top of their licenses.
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