Health Day - ONLINE EDITION

Doctors Want to Provide Best Care Possible to Patients: Survey

But time spent dealing with electronic health records one of the biggest obstacles they see to doing that

  • Print

WEDNESDAY, Oct. 9 (HealthDay News) -- Doctors want to provide quality health care to their patients, and when there are obstacles to doing that they report more dissatisfaction with their jobs, a new survey finds.

One of the biggest obstacles to giving their patients the best care possible is electronic health records, the physicians noted. Still, four of five doctors said they wouldn't go back to paper, just that they wanted electronic health records to be less cumbersome and time-consuming to use.

The survey was conducted by RAND Corp., a nonprofit research organization, and funded by the American Medical Association (AMA).

"Physicians are pleased and happy professionally when they perceive that they're giving high-quality patient care, and they're unhappy when they can't meet patients' needs and when there are barriers to quality patient care," said study author Dr. Mark Friedberg, a natural scientist with RAND and a practicing general internist in Boston.

"The findings on [electronic health records] were a real surprise to us," Friedberg said. "They had a very important and powerful effect on physician satisfaction."

"Medicine isn't a job. It's not even just a career. Medicine is a calling," AMA President Dr. Ardis Dee Hoven said during a Tuesday news conference. "But the bureaucracy can take a toll on even the most dedicated physicians. Over time, the obstacles to providing patients with high-quality care can diminish physician satisfaction."

Happy doctors are important because they're a kind of marker for the health of the whole system, she said.

"We can look at physician satisfaction as an indirect measurement that shows us the factors that are barriers to first-rate medical care," Hoven said. "[When those barriers are removed] satisfied doctors working in a good environment leads to satisfied patients."

The survey results were released online Oct. 9 on RAND's website.

Friedberg and his colleagues interviewed doctors from 30 physician practices in six states. They purposefully made sure they had a wide variety of practices -- small, large, specialty, independent and part of a larger health care system -- in the study. They interviewed a total of 108 physicians and 112 practice leaders or clinical staff from these practices. The researchers also sent surveys to about 450 doctors in these practices.

Doctors were happier when they had more autonomy and greater control over the pace of their work. Physicians in physician-owned practices or partnerships also were more likely to report satisfaction compared to those in hospital or corporate-owned practices.

When the pace of work or excessive administrative work led to limited time with patients, doctors were more likely to be dissatisfied, the survey found.

One doctor surveyed felt he was shortchanging patients by seeing more people throughout the day. "I guess it's the wave of the future to be able to see more patients in a shorter amount of time," the primary care physician said. "I just don't think a 15-minute visit is remotely feasible."

Most physicians were satisfied with their income levels, according to the report. They also said having enough well-trained staff was important.

Doctors expressed uncertainty about the upcoming changes to health care based on the Affordable Care Act. Currently, it doesn't seem to have a big impact on physician satisfaction with the exception of the incentives for adopting electronic health records.

Most doctors approve of electronic health records in concept, but right now they require physicians to input a significant amount of data, and most of that data needs to be entered in template form, which doesn't leave them much freedom to add personal notes. Entering this data often interferes with patient time, Friedberg said.

One doctor put it this way in his survey response: "All of the [electronic health records] that I've seen have actually been very time-consuming for physicians. Physicians have to order everything themselves, which is time-consuming, and do all the data entry themselves, which is time-consuming. [Electronic health records] at this point in the development are not timesavers for physicians. They're big-time sinks."

More importantly, the systems don't all "talk" to each other, so there's not necessarily a seamless transition of records from one doctor to another or from a hospital to a doctor.

The implementation of electronic health records has also been more expensive than many initially expected, according to the study.

"Most physicians prefer [electronic health records] over paper," Friedberg said. "It makes it easier to access patient information from home or far away. It's easier to track performance metrics. But physicians feel the time spent on data entry is time wasted. And the user interfaces are not well designed for a physician busy with patient care. It seems there may be some fundamental problems with the technology that still need to be solved."

Hoven agreed: "[Electronic health records] have to be useable and have to be more intuitive. They have to make workflow easier, not more complicated."

One of the report's authors said the findings provide fodder for future changes to electronic health records.

"The RAND report was very successful in pointing us in several directions," said Dr. Jay Crosson, group vice president for professional satisfaction, care delivery and payment for the AMA. "The intensity of feeling on the [electronic health records] issue was a little bit surprising. I think we'll likely be working with the vendor community and maybe the government to improve [electronic health records]. We need to increase awareness among vendors that physicians need the ability to use [electronic health records] effectively and quickly."

More information

Learn more about electronic health records from HealthIT.gov.

Fact Check

Fact Check

Have you found an error, or know of something we’ve missed in one of our stories?
Please use the form below and let us know.

* Required
  • Please post the headline of the story or the title of the video with the error.

  • Please post exactly what was wrong with the story.

  • Please indicate your source for the correct information.

  • Yes

    No

  • This will only be used to contact you if we have a question about your submission, it will not be used to identify you or be published.

  • Cancel

Having problems with the form?

Contact Us Directly
  • Print

You can comment on most stories on winnipegfreepress.com. You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

You can comment on most stories on winnipegfreepress.com. You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

Have Your Say

New to commenting? Check out our Frequently Asked Questions.

Have Your Say

Comments are open to Winnipeg Free Press print or e-edition subscribers only. why?

Have Your Say

Comments are open to Winnipeg Free Press Subscribers only. why?

The Winnipeg Free Press does not necessarily endorse any of the views posted. By submitting your comment, you agree to our Terms and Conditions. These terms were revised effective April 16, 2010.

letters

Make text: Larger | Smaller

LATEST VIDEO

RMTC preview of Good People

View more like this

Photo Store Gallery

  • Marc Gallant/Winnipeg Free Press. Local- Peregrine Falcon Recovery Project. Baby peregrine falcons. 21 days old. Three baby falcons. Born on ledge on roof of Radisson hotel on Portage Avenue. Project Coordinator Tracy Maconachie said that these are third generation falcons to call the hotel home. Maconachie banded the legs of the birds for future identification as seen on this adult bird swooping just metres above. June 16, 2004.
  • Horses enjoy a beautiful September morning east of Neepawa, Manitoba  - Standup Photo– Sept 04, 2012   (JOE BRYKSA / WINNIPEG FREE PRESS)

View More Gallery Photos

Poll

Now that the snow is mostly gone, what are your plans?

View Results

Ads by Google