Burnout is down, but physicians are still working long hours

For the report, AMA surveyed over 12,400 physicians in 81 health systems and organizations across 31 states.

Overall, the report found that the percentage of physicians reporting burnout in 2023 was 48.2%, down from 53% who said the same in 2022.

At the same time, the number of hours physicians worked a week slightly increased from an average of 58.6 hours to 59 hours. In 2023, physicians spent 27.3 hours on direct patient care, 14.1 hours on indirect patient care, and 7.9 hours on administrative tasks.

The number of hours physicians worked also varied by specialty:

• Hospital medicine: 67.3 hours.
• Internal medicine: 59.8 hours.
• Obstetrics and gynecology: 59.1 hours.
• Family medicine: 55.5 hours.
• Pediatrics: 54.3 hours.
• Emergency medicine: 53.3 hours.

When it came to "pajama time," or time outside of normal working hours, 20.9% of physicians said they spent more than eight hours a week outside of work on administrative tasks in 2023, similar to 2022. In addition, 14% said they spent six to eight hours outside of work on administrative tasks, while around 26% said they spent zero to two hours.

"With little movement on time spent on the EHR outside of work, this signals an urgent need to find solutions to reduce physicians' pajama time," AMA wrote.

5 ways to reduce physicians' pajama time

At Sutter Health, physicians decreased the time they spent on the EHR each day by 14%, going from 54.53 minutes to 46.69 minutes. Here are five ways Sutter Health helped reduce their physicians' pajama time.

1. Provide help with documentation

Sutter Health has trained its medical assistants to be documentation specialists, which has made the process more efficient.

"It makes it not only a more efficient time period, but more comfortable for the patient," said Laurie Gregg, an ob-gyn and chief wellness officer for Sutter Independent Physicians, noting "there's a medical assistant the patient knows who is notetaking, helping with procedures and chaperoning. That is a big multi-tasking win."

"That was done at our Sutter independent physician medical group level and is still being used in those specialties who need chaperones," Gregg added. "The patients almost don't notice that a chaperone is in the room because they are busy doing their work and then we get half our note written and our mammogram order keyed up before the visit is over."

2. Rely on physician champions

To incentivize physicians to be more efficient, Gregg said that Sutter's independent physician association has EHR-optimization visits with physicians who are EHR champions.

Physicians who have had sessions with an EHR champion say that "they really notice that they've cut their time going forward," Gregg said. The sessions are helpful for both physicians who are struggling with the EHR and those who want to further improve their skills.

3. Educate physicians about note bloat

Rather than documenting time for each task during outpatient visits, physicians can bill based on documentation of medical decision-making or the total time spent on an encounter.

"Now that we can use time-based billing instead of note-documentation billing, that has really made the difference for me and a lot of my colleagues," Gregg said, adding that "we educate to that a lot" since not enough physicians know about time-based billing.

4. Use AI for documentation or response

Sutter Health has also turned to artificial intelligence (AI) to help with documentation and patient portal messages.

"AI listens to the patient-physician visit and drafts the visit note,” Gregg said. She added that AI also "can craft an initial response to a patient message that the physician revises and sends back."

Currently, initial pilots of AI technology through the health system have shown promise, and they are being analyzed for improvement.

5. Create a team to manage inboxes

At Sutter Independent Physicians, physicians are encouraged to complete innovation projects every six months. One of the preprepared innovation projects is a team inbox, which is designed to decrease the workload for physicians.

"[W]e don't dictate exactly how they" handle the project, Gregg said. "We say over six months, if you can create something where not only the doctor touches the inbox, but at least somebody else—medical assistant, nurse—then that meets one criteria for the innovation project and it's another incentive for them."

Advisory Board's physician retention resources

For more insights on ways to retain physicians, check out these Advisory Board resources:

• Gaining an edge on the competition: The key to winning and retaining physician talent.
• Your two-pronged approach to addressing—and preventing—physician burnout
• How fostering a culture of respect can combat physician burnout
• Becoming the physician employer of choice

(Berg, American Medical Association, 8/13; Taylor, Becker's Hospital Review, 8/13)