Nearly half (46%) of ob.gyn.s, and physicians generally, said in a new survey their employers were not paying enough attention to the extent of burnout among their physicians.
Findings of the survey were reported in Medscape’s Ob/Gyn Practice Issues Report 2024.
“It’s a big problem,” said Nigel Girgrah, MD, PhD, chief wellness officer at Ochsner Health in New Orleans, Louisiana. But he added he expects that 46% level to drop in the next few years.
“There’s an increasing awareness among executives in healthcare that well-being is a leading quality indicator, if not the indicator, of favorable outcomes in patient care, staff turnover, and other vital areas,” he said.
However, there are structural barriers that threaten work-life balance, says Eve Espey, MD, MPH, chair of the Department of Obstetrics and Gynecology at the University of New Mexico in Albuquerque. In a specialty made up mostly of women, she notes, there is no federal policy on paid medical leave, leading to women ob.gyn.s pulling double duty at work and at home.
“To me, the most important way to engage on burnout is not offering yoga lessons; it’s dealing with these big structural issues,” she said.
What’s Driving the Burnout
Ob.gyn. survey respondents said the top two reasons for burnout are too many bureaucratic tasks, such as paperwork and charting, (cited by 62%) and too many hours at work (cited by 53%).
More than half (55%) said the paperwork burden had increased in the past year; 34% said it stayed the same; and 11% said it had decreased.
“I think the regulatory burden has gotten higher for most of my colleagues,” Dr. Espey, said. “Coding and billing rules are pretty opaque to most ob.gyn.s and a lot of the tasks that used to be done by medical assistants are now done by physicians.”
‘Big Hope’ Is AI
“The big hope on the horizon is AI and programs that do basically what scribes do,” Dr. Espey said. “People feel like that will be a game-changer when it comes to paperwork.”
She said the root problem is that EHRs are used mostly for billing, not for communication. Two thirds of the respondents said they sometimes or always copy and paste from charts, which can lead to note bloat.
“You can’t write concise notes in EHRs,” Dr. Espey said. “I think this is an area where the promise of AI would be very helpful.”
Nearly 40% of ob.gyn.s were enthusiastic about the potential for AI in the survey; 43% were neutral on the subject; and the remainder were apprehensive. Asked about how their practices have most commonly used AI so far, 23% said it was used for researching conditions. The next highest usage was for help in diagnosing conditions (mentioned by 13%).
More than half (53%) of the ob.gyn.s said they thought AI would free up more time for patient conversations and care while only 38% of doctors generally thought it would.
Hard to Spend More Time With One Patient
Nearly three in 10 ob.gyn.s said they have a patient quota at their workplace, compared with one in four for physicians generally.
“Clearly, there can be thresholds (for ob.gyn.s) in the office and ambulatory care settings,” said Catherine Cansino, MD, MPH, a Sacramento ob.gyn. affiliated with University of California–Davis Medical Center. She added that on the inpatient side, patient quotas come from the allotted time an ob.gyn. can spend with a patient. “There are definitely hoops to jump through when we want to spend more time with a patient, and it can be tough for them to get a follow-up appointment.”
Most ob.gyn.s (62%) in the survey would give their employer good ratings for offering an engaging and welcoming atmosphere. But nearly 40% said their employer emphasizes patient quotas and CPT codes more than care quality.
Data for this report were drawn from several Medscape surveys performed between March and October of 2023.