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Can NPs and PAs Help or Harm Burned Out Physicians?

Can NPs and PAs Help or Harm Burned Out Physicians?

Every new study seems to confirm it: Burnout is an ongoing problem in today's medical practice. The 2016 Survey of America's Physicians commissioned by the Physicians Foundation found that nearly half (49 percent) of 17,000 physicians surveyed reported feeling burnt out some or all of the time.

Burnout may result from a combination of factors including the Affordable Care Act (ACA), the introduction of EHRs, and other technology and unprecedented regulatory pressure, according to Catherine Miller, a senior risk management and patient safety specialist for the Cooperative of American Physicians, a provider of medical malpractice coverage in Los Angeles.  "Historic stressors, including medicine's culture of invincibility and the disciplined and self-sacrificing nature of many practitioners, feed into the problem," she says.  "The analogy to 'the perfect storm' is apropos."

Concurrent with growing stress levels in the doctor's workplace, the increasing availability of advanced practice clinicians brings a logical question: Can reliance on these professionals help lessen physician burnout? 

Some practitioners see significant potential for PAs and NPs to reduce the burnout problem. Others, however, are not convinced.

In an informal February survey on SERMO, the social network for physicians, respondents were asked if they believed the use of PAs and/or NPs can help in reducing or avoiding physician burnout. Fifty-three percent indicated that they do help alleviate work load pressures, while 25 percent said that they create more work and confusion. Thirty-one percent of respondents reported having had issues supervising PAs and NPs in their practice. Some 28 percent indicated that their use raised questions of who has authority in the practice, and 13 percent reported an increase in feeling territorial about their work.  At the same time, 27 percent reported that the use of PAs and NPs had a positive impact on their practice.

Load Sharing and More

Those who advocate for the use of PAs point out a number of advantages.

"Hiring a PA or and NP is an effective way to decrease a physician's workload, and it can have huge benefits for the practice," Miller said.  She cites results such as improved patient satisfaction through reduced wait times and ultimately, a better patient experience.  "A few extra unhurried minutes enjoying your patient's company is good for everyone," she says, adding that less time spent on routine tasks enables physicians to focus on patients with more complex needs. 

"Reduction of work load is the number one way in which an [advanced practice clinician] can help reduce burnout," says Anthony Fisher, associate medical director of primary care for Sentara Medical Group in Hampton, Va. He cites tasks such as handling urgent-care visits, improving access by seeing see new patients in a timely fashion, and following up on hospital discharges as areas advanced practice clinicians can assist physicians. Working as a care partner with a physician to promote continuity of care can also be valuable in tasks such as educating a diabetic or following a myriad of chronic illnesses. 

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