As a consequence of the dynamic environmental trends and market forces that are reshaping the healthcare industry, the clinical practice of medicine is rapidly transforming. Physicians who operate on the “front lines” are now facing unprecedented change. And this change has contributed almost universally to growing levels of uncertainty, stress, and anxiety among healthcare professionals. When I consider my own medical practice, the triggers are easy to identify:
- Patients are having difficulty paying for costly tests and procedures out of pocket. The “affordability gap” continues to complicate treatment conversations and strain patient-doctor relationships.
- Patients are presenting with more complicated diseases, while new treatments are seemingly coming out every week. While fascinating, the effort to continually marry new therapies to confounding diseases exerts professional pressure on practitioners.
- New advances in emerging fields such as genetics and robotics are happening at an accelerating rate. Once again, physicians are challenged to maintain pace with state-of-the-art medicine in order to deliver the best patient care.
- The expanded legislative mandate has introduced new regulations that directly impact the method and tools associated with the practice of medicine, as well as how it’s being reimbursed. The new Meaningful Use (MU) regulations, for instance, introduce practical challenges (e.g., EHR implementation) and corresponding financial risk (e.g., e-Rx penalties).
- Insurance companies often deny recommended treatments by categorizing them as “medically unnecessary,” in spite of the fact that they have limited knowledge of the patient, the patient’s health situation, and the physician’s decision path.
- The cost of medical liability insurance has skyrocketed. Frivolous lawsuits have become pervasive in an industry that needs to better address the issue of tort reform.
While I and many other doctors continue to face these rising pressures, there are laws on the books that prevent us from collectively bargaining. We are essentially independent operators, isolated from other physicians as a result of the demands of our practice and by legal convention. It should come as no surprise that nearly half of the nation’s doctors report a symptom of burnout (“Doctor Burnout,” Mayo Clinic; USA Today, 2012). The statistics relating to early physician retirement are equally as scary, especially when you consider the projected clinical shortages over the next decade.
With all this change and all its related anxiety, I’ve often asked myself if there’s a mechanism of support. Interestingly, I think I may have found my answer in social media, which is helping me to build connection and community with others who are facing many of the same issues and feeling similar pressure. Social sites and tools like Facebook and Twitter have helped me connect with other doctors. However, they don’t address my clinical needs. Channels to support in-depth clinical and scientific consultations with other physicians haven’t been developed.
Sermo is an online social community that was specifically developed for physicians. With broader reach and more meaningful engagement than other clinical communities, the site can help with everything from second opinions on complicated patient cases to asking for practice management or travel recommendations.
iConsult, Sermo’s peer-to-peer collaboration resource, makes possible real-time, virtual consults at the point of care via the Web or mobile app. I’ve integrated iConsult into my practice when I’m faced with a complicated case. The ability to collaborate and effectively crowdsource medical insights has helped me, and other physicians, to more effectively diagnose disease, treat patients, and solve cases.
Can social media help address physician burnout? Based upon my experience, the answer could be yes. Beyond the ability to drive collaboration, social media and community have the indirect benefit of mitigating the stress and anxiety of running a medical practice. I’ve got support and a developed network to reach out to whenever I’m feeling overwhelmed.
It can sometimes feel as though the people who most want to revamp the delivery system are the least experienced or qualified to do so. Many seem to have no idea what it takes to provide quality medical care for patients, yet they are self-appointed experts who establish the requirements and issue mandates that govern physicians’ practice. More people need to be asking questions, and physicians need to be better integrated into and considered in the discovery process.
Perhaps social media can help doctors find their shared voice. Perhaps crowdsourcing can help us put the person back in the patient, while simultaneously putting the doctor back at the top of the healthcare team. Only then will healthcare truly excel, and only then will we begin to address the very real risk of physician fatigue.
Dr. Linda Girgis MD, FAAFP is a family physician that treats patients in South River, New Jersey and its surrounding communities.
