Remember how the PCMH (patient centered medical home) model was designed to provide better care to patients through a team-based approach?Sure you do because you laughed at how ridiculous it was. Well, now we have this:
“Primary Care Tasks Associated with Provider Burnout: Findings from a Veterans Health Administration Survey,” noted that the challenges that come with undergoing a practice change as immense as transitioning to a team-based model of care “may have led to the unintended consequences of creating new stresses for PCPs, resulting in burnout.”
Ok, stop laughing. This is serious.
How many times can we say we told you so?
Researchers broke down tasks PCPs reported performing independently. As noted in the findings,
- 87 percent of PCPs said they evaluated patients and made treatment decisions;
- 80 percent tracked patient diagnostic data and responded to patient diagnostic and treatment data;
- 68 percent intervened on patient lifestyle factors; and
- 65 percent educated patients about disease-specific self-care activities and medications.
PCPs reported some reliance on team members for screening patients for diseases (32 percent), receiving messages from patients (28 percent) and resolving patient messages (43 percent).
When it came to burnout, the researchers reported, “Specifically, intervening on patient lifestyle factors and educating patients about disease-specific self-care activities were significantly associated with PCP burnout.”
It seems to me that there just isn’t enough time to do all this stuff (aka metrics) in the regular hamster wheel of family practice (note: in Direct Primary Care there is). That’s an obvious conclusion, right? So what do these authors recommend?
- Their suggestion: “Expanding the roles of nurses and other health care professionals to assume responsibility for these tasks may ease PCP burden and reduce burnout.”
- They suggested that a potential strategy to combat PCP burnout would be to “enable PCPs to share this responsibility with other team members,” a transition that would require adequate staffing, focused training and standing orders.
Brilliant! More team members!
So, in conclusion, a massive cluster f*ck called PMCH with huge teams has caused burnout so to fix it we should keep adding (and spending on) more team members until it is fixed or becomes the blob and takes over the world. Love it.