Physician Burnout: Call with Centers for Medicare & Medicaid Services (CMS) Office of Clinician Engagement

By Policy and Advocacy Brief posted 04-11-2017 14:54


In last's week's Advocacy Snapshot, we shared that Christopher Gonzalez, MD, Chair, AUA Public Policy Council; Patrick McKenna, MD, Chair, AUA Workforce Workgroup; Amanda North, MD, Member of the Leadership Class project on physician burnout; and AUA staff conferenced with the two physician co-leads of the Centers for Medicare & Medicaid Services (CMS) Office of Clinician Engagement. 

The goal of the new Office of Clinician Engagement is to drive a coordinated approach to improve the clinician experience. CMS is initially doing a lot of listening and plans on hosting listening sessions around the country around a few priority areas of administrative burden. They recognize that administrative burden contributes significantly to burn out. Therefore, the agency is looking critically at how we address or learn about addressing the current epidemic of physician burnout, compassion fatigue, and the flip side of that: how we work to support physician resilience.

The AUA noted that – with our annual national census – we are well positioned to help CMS with this topic area. Last year’s Mayo study put urology as the highest surgical specialty on the list for physician burnout. This raised concern because urology also is facing one of the biggest shortages, needing somewhere between 16,000 to 20,000 urologists by 2025. If the burnout rate is so high, this will further affect the supply in the future. The AUA followed up on the Mayo results with our own study and the good news was that urology was not the highest; we are about 40 percent just like other specialties.

Members of the AUA’s Leadership Class conducted research on the results of the AUA Census to assess physician burnout. The most important factor in burnout is the number of hours a physician works in a week; the higher the number of hours one works, the more likely they will be burned out. The drivers to increased work include the use of electronic medical records. For older physicians leaning toward retiring, they are more affected on their decision to retire by new government regulations.

One or two person practices have lower burnout rates. Yet, they have higher administrative costs, which can lead to challenges to staying in practice.

Ethnicity and gender do not have an effect on burnout. Urology is probably ahead of other groups. The AUA already has engaged other groups like Mayo and Kaiser that are finding that it is important to have local programs to address physician burnout. This work presents an opportunity for AUA and CMS to partner to develop long-term strategies to address burnout. Addressing physician burnout does not happen overnight, said the AUA.

The AUA and CMS discussed three opportunities for partnership:

  1. Collection and dissemination of resources and best practices. How do we scale AUA’s work on burnout?
  2. Building the fact base (e.g., AUA data from the Census, literature) with data collection and on drivers that lead to burnout and the interventions that work to mitigate it.
  3. Getting at burden at the source. Getting at it whether it is being driven in things such as government regulation or physicians feeling that they don’t have a role in implementation. What are the opportunities to get at burden and burnout at the source?

The AUA will continue to update you on ways we are addressing workforce issues such as physician burnout.