Before my husband John died he wrote me a letter in residency. The letter told me that things would get better. He would have more time for the kids. We would travel. I think a lot of medical training and work is banking on the promise of things getting better. They do not always get better.
In 2018 I started a nonprofit with the mission to increase awareness of and help prevent physician burnout and physician suicide. I also welcomed baby Naveen, and as a result, things have been moving a bit slower of late.
I love everything about my youngest son, but for me personally, he is an obvious reminder of how our personal lives influence the important work of health IT and vice versa. Investing time in my little family has directly impacted not only the amount of work I’ve been able to accomplish in the last couple of months, but also has made me more sensitive to narratives about work life balance.
My mission to reduce physician suicide is also a personal one; one of the main characteristics of the health IT industry is that it seeks to improve or solve very human problems – usually on the patient’s end. Now, the healthcare industry is realizing that the technology we develop needs to enhance not only patient health, but also physician experience, a major contributing factor to success in that area.
Last year was the year of the electronic health record. The linked issues of physician burnout and physician suicide finally made it into public discourse, appearing in national news, and overwhelmingly, physicians asserted that electronic health records were part of the problem.
After working long hours with patients, physicians are putting in yet more long hours recording their work. The computer separates physicians and patients, replacing time doctors spend on meaningful interactions with onerous data entry. Multiple studies have suggested that personalization makes a difference in doctors’ job satisfaction; healthcare systems that support great workflow and personalization result in fewer complaints about electronic health records. Investing time in creating or adopting a functional, intuitive, well-organized electronic health record has a direct positive impact on physicians’ happiness with their jobs.
Narratives about physician burnout emphasize the importance of empowering physicians with technology; there is already an understanding across most industries that the quality of technology can enhance or detract from workplace satisfaction. Electronic health records, so far, have lagged in this trend; most systems frankly need a redesign.
My nonprofit, the Sharp Index, was formed out of my grief over losing my former husband to suicide during his medical residency. This is not a one time thing for me. It is not a “wellness program” in a healthcare system.
Last week my 11 year old sat me down and asked how dad really died because she wanted more answers about all the factors. How much of it was mental illness? What illness did he have? What were the signs? Some of her classmates asked her and she started pretending she was sick so she wouldn’t have to go to school and talk about suicide. I didn’t know how to answer her questions about the percentages of fault for why her father isn’t here. I can’t give her all the answers. I’ve quit a job when it was too much to face the reality of suicide loss every day. If we believe mental health is real, then medicine should do more to be responsible for healing, including health IT.
Initially, when I discussed his loss, many physicians didn’t want to admit there was a problem. Now the discourse about burnout and suicide is more open. Solutions are still protected. Many want to keep the issues and potential solutions within the circle of physicians. They want to be the experts; I was more concerned with ensuring that no other children lose their fathers than with getting published in a prestigious journal. I wanted to heal the healers, and to have an honest discussion about the reasons why physicians have a higher risk for dying by suicide. When one of the reasons for this high rate is a failure of technology, the importance of resolving these problems and empowering physicians to succeed becomes a personal concern.
Healthcare systems have seen enormous spending in implementing records. But they need an update, and that necessity should be viewed as an opportunity to use smart design and bring existing technology into the modern age, emphasizing functionality and user experience. It means that the billions of dollars already spent on the transition from paper records to electronic copies of those paper records is not the end of the investment – it is the beginning.
We have more potential to improve healthcare than before. People point fingers at Health IT like they never did before. This means Health IT can affect the changes we need.
We know that having records that match physician workflow matters. Having patient records at the point of care matters. When we want to fix a problem we can ask people what is wrong. With physician burnout, Health information technology and clinical informatics have a huge potential to improve physician lives. We are working in the area many people say causes their unhappiness. There is so much room for improvement.
Many years ago I got a promise that things would get better. I still think they will, in John’s memory.
The views and opinions expressed in this blog or by commenters are those of the author and do not necessarily reflect the official policy or position of HIMSS or its affiliates.
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