With the increased use of telehealth, many benefits have been realized. First and foremost, our patients have benefitted. However, I would argue that an additional significant benefit of telehealth is the potential it has to improve the lifestyle of physicians, and even more so for those who provide services from a home office. Given that there is an increasing shortage of physicians, it’s not much of a stretch, to further argue, that improving the lifestyle of our physicians, will further benefit our patients. Job satisfaction for physicians is likely to lead to more physicians staying in the field, staying in the field for longer, and not decreasing the size of their practice.
The vast majority of doctors choose their work because they like to help patients. The practice of medicine is a calling. It is not hyperbole to say that physicians see it as an honor to be able to work at the convergence of this field that combines both the science and the art of medicine to improve the health of their patients. They have dedicated their lives to the practice of healing others and decreasing suffering. Thus, an additional benefit that telehealth offers physicians, is the satisfaction of delivering care to patients who might otherwise not receive that care or who would receive it in a less timely manner.
Telehealth was initially developed to provide services to underserved populations such as those in correctional facilities and rural areas. Its use has become much more ubiquitous as other benefits have been realized. Not only are patients seen who might have otherwise been without services, but the increased ease of seeing patients allows for more timely evaluation and follow up. Additionally, the use of specialists to consult with the primary care physician or see the patient themselves, provides a higher quality of care (when the expertise of the primary care physician is exceeded). When patients have more timely evaluation and follow up, there is also less likelihood of the disease process progressing to a stage that is more costly. That cost is measured, not only in terms of dollars and cents, but also, in terms of life satisfaction, less pain, and improved function at work and home.
Physician burnout is a growing concern in the field. It has become a leading topic of discussion in forums for physicians, medical educators, and recruiters. Leading national media outlets such as Forbes and the Washington Post have taken note and publicized a study in 2014, that showed a further increase in physician burnout than that first noted in 2011 (45%). Physician burnout has been defined many ways but one of the better definitions involves the ability to recover drive and energy before returning to work. Physician burnout is not simply the stress of being a physician. It’s an inability to ‘recharge your batteries’ when not in the office or on call (Dike Drummond, MD Follow him on his website, Happy MD). Evidence of physician burnout includes a large percentage of physicians selling their practices. (CNN by Parija Kavilanz, July 16, 2013 Doctors Bail Out on Their Practices). Most alarmingly, studies consistently show that U.S. physicians have the highest rate of suicide among professionals . There is also an increased rate of physician substance abuse among those experiencing burnout. While the rigors of medical school and residency are well documented, the rate of physician burnout is still high once a physician leaves this period of time limited training and starts private practice. The prevalence rate of practicing physicians is estimated to be between 33 to 60%. (Happy MD blog).
Beyond the previously noted decreased number of physicians due to attrition, physician burnout affects patients and staff while the physician is practicing. It’s been linked to increased medical errors which would lead to increased malpractice rates. It’s been noted that there is lower patient compliance and satisfaction with care. Additionally, there is decreased physician professionalism and quality of medical care provided. (Happy MD blog)
While much has been written about personal and organization preventive measures to avoid physician.
I would argue that the top three are:
It is the ability of telehealth to easily provide all three of these, that lead to me writing this article.
Telehealth’s ability to improve work life balance is obvious on several levels but until one is engaged in it, I don’t think that it’s potential to do this is fully realized. For physicians who can work from a home office, the benefits are substantial. Not only does one gain precious commute hours in a schedule that is already jam packed, but many other factors also come into play. The simple act of being able to walk to one’s own kitchen when you have a chance to grab a cup of coffee or lunch and engage with family/pets provides a grounding that doesn’t occur at a hospital/clinic setting. Avoiding the hassle and stress that many experience during a commute also starts the day off better. Telecommuters routinely list a quieter atmosphere, less distractions, and the ability to be more productive as benefits of working from home. The list is long and different for each physician, but the many ways that working from home can provide a more relaxed and peaceful work environment is well documented in the history of telecommuters.
There also may be an opportunity to work less hours as there is a substantial cost savings that has been well documented for those who telecommute. The cost savings of gas and automobile costs not incurred is obvious. However, the additional cost savings of meals at home, reduced dry cleaning, and other factors add up substantially. For those doctors who moonlight for additional pay, it’s possible that they could moonlight less, given the cost savings of telecommuting.
Though not always the case, the work of someone doing telehealth is typically limited to certain hours compared to that of a physician working in a clinic or hospital. In fact, doctors doing telehealth ER shifts, often find themselves having down time that they can put to use, very differently, than they would if sitting in a hospital.
As previously noted, most physicians consider their work to be a calling and are honored to be involved in improving someone’s health and wellbeing. The ability to reach patients who might not otherwise have been reached makes the work of telehealth very meaningful for a large number of physicians. Similarly, delivering care in a more timely manner to prevent morbidity and mortality is also a rewarding promised of telehealth.
I think it is important to be reminded of the oft quoted expression “physician heal thyself”. Attending to one’s own health and wellbeing as a physician, allows physicians to be better providers of health to others. The increased work-life balance that providing telehealth from home can offer a physician, may well be the answer for many physicians experiencing burnout. It may allow them to recharge not only their batteries, but to better care for those they swore an oath to care for.
Elizabeth Ferguson, MD
Director of Behavioral Health Business
Director of Psychiatric Services