In July 2018, NCMB surveyed a random sample of licensed physicians and PAs in the state, receiving more than 2,600 completed responses. NCMB periodically surveys licensees to better understand issues affecting clinicians and the practice of medicine in North Carolina, and to generate ideas for possible resources and services to support licensees. This year’s survey focused on three main topics: professional burnout, the effects of the opioid overdose crisis and telemedicine.
BIGGEST CHALLENGES
NCMB asked respondents to name the biggest challenges faced by clinicians. The top three mentioned were:
1. Electronic Health Records (EHR)
2. Increasing number of quality metrics
3. Maintaining healthy work/life balance
PROFESSIONAL BURNOUT
Some 35 percent of survey respondents reported experiencing symptoms of burnout lasting three months or longer. That’s actually quite a bit better than the national trend of 42 percent, as documented by the 2018 Medscape National Physician Burnout & Depression Report. About 52 percent of respondents to NCMB’s survey indicated they have not experienced prolonged symptoms of burnout, while another 12 percent indicated they are not burned out or preferred not to say.
Top 5 factors driving burnout
1. Too many administrative tasks (charting, paperwork)
2. Increased performance expectations (quality metrics, patient load, etc.)
3. Spending too many hours at work
4. Lack of control/autonomy
5. Increasing computerization of practice
Top 5 consequences of burnout
1. Dreading the work week
2. Cynicism or negative outlook
3. Exhaustion that is not relieved after taking time off
4. Feeling as though my work doesn't make a difference
5. Lack of empathy for patients
ADDRESSING BURNOUT
Of those who indicated they have experienced burnout, 81 percent have not sought professional assistance. The top reasons for not seeking help were:
1. Burnout symptoms were under control
2. Burnout is just part of the job
Fear of being labeled and concern about possible negative impact on employment were also top concerns.
A large majority of respondents – 82 percent – indicated they have at least some level of confidence they can successfully manage burnout. Most reported that they are only “somewhat confident” about their ability to cope. The most common coping strategies included engaging in exercise, yoga and/or meditation, talking with colleagues, family and friends, and making professional changes such as changing jobs or reducing responsibilities.
PRACTICING AMID THE OPIOID CRISIS
More than half (58 percent) of survey respondents reported that their clinical practices have been impacted by the opioid overdose crisis. The most common response documented by NCMB’s survey is for licensees to discontinue prescribing opioids for the treatment of chronic pain. Some 43 percent of respondents who said they were impacted reported that they have elected to no longer treat chronic pain patients with opioids. About 35 percent of respondents indicated that they continue to treat patients with chronic pain with prescription opioids, albeit with greater caution. Half of respondents who were impacted said that they consulted the CDC Guideline on Prescribing Opioids for the Treatment of Pain or other clinical guidance when determining how to adjust practice.
TELEMEDICINE: STILL DEVELOPING
Just 14 percent of survey respondents have incorporated telemedicine into their practices – but those who have say it’s been a positive addition. About 63 percent of licensees currently practicing telemedicine at least some of the time report that it has had a “somewhat positive” or “positive” impact on their practices. Positive how? The top positive impact reported was that telemedicine makes it easier to monitor patients who are less mobile and have difficulty coming in for in person care. Respondents also indicated telemedicine also helps them to see more patients overall. Of the barriers to incorporating telemedicine, limitations on the ability to conduct a thorough exam and insurance reimbursement round out the top of the list.
Read a complete report of survey findings
