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Rheumatology, Managed Care and Burnout

Issue: November 2017

ByLeonard H. Calabrese, DO

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I recently chaired a CME program in Chicago, where I asked a polling question about which “obstacle” was the greatest impediment for effective patient care. Many of the usual suspects were among the responses, such as time crunches, hassles with electronic medical records, patient engagement and adherence issues, and keeping up with the literature, as well as insurance and financial challenges.

What was the winner? The hands-down winner was the financial obstacles all rheumatologists face. These obstacles are clearly stressful because these are not in our control. Accordingly, our panel of experts in this issue Cover Story, which starts on page 16, are spot on to help us understand these managed care hurdles, even though we have no quick fixes for now.

More Pressure

In general, physicians are under increasing pressure to see more patients and produce greater patient satisfaction scores. However, the hurdles along the way do not help any of us achieve these goals.

Shanafelt and colleagues, in their study “Changes in burnout and satisfaction with work-life balance in physicians and the general U.S. working population between 2011 and 2014,” found physicians remain at an increased risk for burnout and are less likely to be satisfied with work-life balance. The researchers found more than 50% of physicians reported burnout, which was a 10% increase from burnout rates reported in 2011. Among the obstacles contributing to worsened work-life balance satisfaction were financial obstacles, loss of job satisfaction and burnout.

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The Mindful Rheumatologist

To end on a positive note, I think there are ways to address these stresses. As we go to press with this issue of Healio Rheumatology, I am looking forward to my upcoming participation in a symposium at the American College of Rheumatology Annual Meeting in San Diego entitled, “The mindful rheumatologist and the science of stress.” This will be the first time this topic is tackled head on in the context of a major session. I will have more to say about burnout in subsequent issues of Healio Rheumatology.

Thanks for reading this issue of Healio Rheumatology. Please send me your comments on the topic of managed care and burnout, or anything else that may be on your mind. I would like to hear your thoughts. You can share your comments with me by email at calabrl@ccf.org or follow me on Twitter @LCalabreseDO or @HealioRheum.

• References:
• Melnick, ER, et al. Mayo Clin Proc. 2016;doi:10.1016/j.mayocp.2016.09.003.
• Shanafelt, TD, et al. Mayo Clin Proc. 2015;doi:10.1016/j.mayocp.2015.08.023.

• For more information:
• Leonard H. Calabrese, DO, is the Chief Medical Editor, Healio Rheumatology, and Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer Chair of Clinical Immunology at the Cleveland Clinic.

Disclosure: Calabrese reports he is a consultant for Genentech, Pfizer, Bristol-Myers Squibb, GlaxoSmithKline, Sanofi, Jansen and AbbVie; and is on the speakers bureau for Genentech, AbbVie and Bristol-Myers Squibb and Crescendo Bioscience.