Caring for Clinicians: Our Commitment to Alleviating Physician Burnout

A 2022 survey from the American Medical Association showed that nearly 63% of physicians experienced at least one manifestation of burnout, appearing as emotional exhaustion, lack of empathy, and a sense of low personal accomplishment, in 2021.

Left unchecked, burnout can lead to a host of issues for physicians, including broken relationships, alcoholism, and even suicide. Alarmingly, approximately 300 - 400 physicians in the U.S. die by suicide annually, and female physicians are up to 400% more likely to commit suicide when compared to females in other professions.¹ An estimated 1 million Americans lose their physician to suicide each year. ²

Burnout has been an area of intense interest for Aric Coffman, M.D., M.B.A., since long before joining Honest Medical Group as CEO in 2021. As a general surgeon and health executive in the Pacific Northwest, he and his leadership team embarked on “listening rounds” to address clinician burnout and turnover issues. The process involved meeting with primary care physicians (PCPs) to discuss their pain points and potential solutions.

“Providers told us they felt trapped in a Catch-22 of having to go fast and provide an excellent patient experience without the resources needed to care for their patients, especially patients with complex medical needs,” Coffman says. “They also cited workflow inefficiencies and administrative tasks as major annoyances.”

Coffman and his team crafted a comprehensive solution, drawing inspiration from a Mayo Clinic Proceedings Model co-authored by Tait D. Shanafelt, M.D., a hematologist and thought-leader at Stanford Medicine, and John H. Noseworthy, M.D., president and CEO emeritus of Mayo Clinic. Within 18 months of the implementing changes, PCP turnover rates fell from 17% to 5%, with similar turnover reductions for medical assistants and nurse practitioners. As burnout abated, physician engagement scores rose.

The power of physician engagement

The Mayo model defines engagement as the “positive antithesis of burnout […] characterized by vigor, dedication, and absorption in work.” Engagement is essential to professional fulfillment. However, engagement can be elusive in the fee-for-service environment. Fee-for-service models tie compensation to relative value units (RVUs), and physicians feel saddled with inefficient workflows and a heavy electronic medical record (EMR) documentation burden.

“The fee-for-service model creates incongruence for physicians,” Coffman says. “There’s a disconnect between how they are evaluated and compensated and the values that motivated them to get into medicine. They also are frustrated by a lack of autonomy to make decisions and solve problems.”

The unique Honest approach

The fee-for-service model prevails in today’s health care system, at least for now. But new approaches to value-based care (VBC) have the potential to transform the way physicians care for their patients and enjoy their life’s work. Simply offering contracts with a few quality incentives won’t move the needle. Today’s physicians need a partner who understands their needs, capabilities, and challenges – and, importantly, collaborates to manage their complex patient population.

“Fostering collaboration is the heart of our clinical model at Honest,” Coffman says. “We partner with primary care physicians to identify their values and goals and develop solutions that align with what’s important to them. Our contracts give physicians the autonomy and support they need to engage in their work fully.”

This type of care model reimburses PCPs based on quality outcomes, not patient volume.

PCPs receive meaningful data, administrative and clinical support, extensive education and training, and a wide range of clinical programs. These resources allow them to deliver care in new, more effective, and more financially aligned ways.

Wraparound care for the most vulnerable patients

Two of Honest’s clinical programs — Care at Home and Care in Motion — embody this supportive approach to VBC.

Care at Home provides longitudinal, home-based care for patients with multiple chronic conditions, a high-frailty index, and barriers to care. “We use a proprietary algorithm to identify a practice’s top 10% of patients most in need of this type of care,” Coffman says. “A nurse practitioner visits them at home as often as necessary, working with a care coordinator, social worker, and nurse manager to ensure patients get what they need. Services can include care navigation, transportation benefits, and even Meals on Wheels. We customize everything to address the patient’s unique challenges and potential barriers to recovery.”

Care at Home Advanced Practice Providers serve as an extension of the practice and support a full-team approach to care while focusing on quality measures. The program frees up PCPs to concentrate their energies on the rest of their patient population, whose needs are less complex.

Another clinical program, Care in Motion, ensures patients transition smoothly to their home or a skilled nursing facility after a hospital stay. Depending on the patient’s needs, care can range from scheduling a follow-up visit with the PCP to providing a home visit. An Honest care coordinator works with nurse care managers and the PCP office so that nothing falls between the cracks.

Early data indicates that Care in Motion helps achieve a nearly 20% reduction in readmissions, representing a significant return on investment, alignment with quality care, and total cost reduction.

The solution that strengthens connections and builds community

The Honest model incorporates new care strategies. But it also hearkens back to when physicians spent more time talking with each other about patients and finding solutions together.

Coffman remembers those days well from his own practice and his father’s. “My dad was a solo practitioner in a small town in Texas. He’d do rounds at the hospital and then go to the doctors’ lounge to discuss cases or call colleagues for their perspectives. I think there was a sense of community and connection back then that has been lost in today’s health care system.”

The Honest solution energizes and engages Coffman for the work ahead.

“The beauty of this model is it establishes communication channels between all the levels of patient care, helping connect the dots and connect providers,” he says. “We’re changing the conversation from RVUs and visits to more meaningful themes that physicians value, like collaboration and quality outcomes. We’re pulling people together in new and exciting ways.”

Learn how Honest’s innovative strategies can improve physician engagement, bolster patient outcomes, and help physicians achieve success in the transition to VBC.

1. Matheson, J., MD FACEP. (n.d.). Physician Suicide. American College of Emergency Physicians. https://www.acep.org/life-as-a-physician/wellness/wellness/wellness-week-articles/physician-suicide

2. National Physician Suicide Awareness Day. (n.d.). https://npsaday.org/