EHRs, financial instability contribute to physicians' pessimism

More than half of surveyed physicians think electronic health records limit them from providing high quality care to patients, according to a report from Leavitt Partners.

Those physicians were more likely to have a pessimistic outlook on the overall practice of medicine. Chief among their complaints are the amount of work that EHR software requires, the software's lack of user-friendliness and how the software interrupts their time with patients.

To improve physicians' experiences with EHRs, vendors and purchasers should work with physicians to help make the software more user-friendly and integrated into daily workflows.

"As EMRs become more and more integrated into the delivery of care, having user-friendly platforms will become increasingly important," Leavitt Partners Research Manager Kerstin Edwards and Chief Research Officer David Muhlestein wrote in the report.

EHRs can also be financially burdensome. New software can eat into hospitals' and health systems' bottom lines. A few years ago, Scripps Health reported weakened financial results at the start of its EHR conversion, a project budgeted to cost more than $300 million and to incur $360.5 million in operating costs.

Physicians also are concerned with their practices' financial stability and management. That contributed to overall pessimism about today's practice of medicine. More than a third of physicians reported feeling somewhat or very pessimistic, and about a third reported feeling somewhat or very optimistic.

The pessimism cuts across the spectrum, with 38% of physicians surveyed saying they are either somewhat or very pessimistic about the practice of medicine. Generally, pessimism is more prevalent in older physicians, with 62% of physicians who graduated from medical school 41 to 50 years ago feeling pessimistic compared to 21% of physicians who graduated within the last five years.

Pessimism about specific areas of medical practice also varies across demographics. Financial pessimism is more prevalent for solo practitioners. But it's difficult to disentangle the causes, Muhlestein said, since younger physicians tend to work for larger, hospital- or heath system-owned practices and feel better about the financial stability of their organizations.

"It is reasonable to think that changing payment models and increasing regulatory requirements make it more difficult for them to achieve financial stability and conduct administrative activities," Leavitt Partners said in the report.

Pessimism about the practice of medicine has financial implications. The more pessimistic were also more likely to stick with fee-based payment models. Policymakers should take physician satisfaction into account when putting value-based care programs in place, according to Leavitt Partners.

"Empowering a variety of physicians to help shape new programs and initiatives may help to improve physician satisfaction, thereby hastening the move towards value," the group said.

But overall, the negativity is harder to address because the pessimism isn't limited to a couple of specialties.

"If it were just a certain specialty, you could create more targeted interventions," Muhlestein said.