Readers Write: Creating Resiliency Among the Newest Generation of Clinicians

Creating Resiliency Among the Newest Generation of Clinicians
By Acey Albert, MD

Acey Albert, MD is director of clinical content for the Epocrates business of Athenahealth of Watertown, MA.

Healthcare is facing an immediate crisis that threatens to undermine our ability to deliver care: a massive clinician shortage that grows larger with each passing day. If that isn’t enough, the COVID-19 pandemic accelerated an alarming rate of burnout, trauma, and disillusionment. In fact, according to Athenahealth’s recent Physician Sentiment Index, the fiscal responsibilities of practicing compounded by the pressure of delivering high-quality patient care contributed to feelings of frustration, with 46% of the nearly 800 physicians participating in the survey reporting feeling burned out a few times a month or more.

While there’s no magic wand that could suddenly wave away this multifaceted challenge, there are small changes we can make today to address some of the immediate drivers of this trend head-on.

Support distracted, fatigued minds with “peripheral brains”

Early in clinical training, there arises a certain bravado about memorizing every rare “zebra” condition in the textbooks. Students and residents are interrogated in front of their colleagues about the most obscure causes of a symptom, reinforcing this drive. At every career stage, the pressure to know it all persists. Rote memorization of obscure facts can distract clinicians from using their brains for what really matters: critical thinking, creative problem solving, and building the clinician-patient relationship.

When clinicians are mentally fatigued, access to clinical decision support tools, or peripheral brains, is more vital than ever. Medical knowledge is growing exponentially. For drug therapies alone, there is an endless flow of journal articles updating the indications, dosing, drug-drug interactions, and side effects. Keeping up with medical knowledge that doubles, by recent estimates, every 73 days is a Herculean task, even before a novel coronavirus emerged to spread devastation and confusion across the globe.

Trusted technology resources have made it possible to compile all of that practical clinical information onto a mobile device. Practicing clinicians are digital omnivores, leveraging access to their desktop and laptop computers, smartphones, tablets, and smart watches, among others. With these digital platforms at hand, clinicians are increasingly becoming managers of medical information rather than mental repositories of it.

Reduce clinical decision time through quick-access mobile solutions

If you think about a typical 15-minute office visit in a busy practice, clinicians must call on a large knowledge base in just a few brief moments: perhaps a few minutes during the patient history, another minute or two during the exam, and then — most importantly — in the last moments of the visit while making a diagnosis and developing the treatment plan. Positioning easily accessible reference data at a clinician’s fingertips means they no longer have to comb through their bookshelves or scour the internet to search for key information vital to their decision-making.

Any tool used during those moments of care needs to be quick, accurate, and intuitive. Certain user preferences can help clinicians rapidly and efficiently access the most-valued and most time-sensitive information. Time spent clicking, scrolling, and typing, or worse, figuring out some novel interface, is time not spent meaningfully interacting with patients. Through the use of familiar interaction models common in non-medical apps, such as swipe right or swipe left navigation, medical app interfaces could be leveraged to more expeditiously deliver guidance. Simple favoriting functions and other self-curation tools can also speed access and create shortcuts for busy clinicians.

Increase patient face-time with mobile technology

Throughout the COVID-19 pandemic, clinicians have increasingly been using mobile apps, both to maintain contact with their patients and as a source of trusted information that goes wherever they do. Compared with a desktop or laptop computer, mobile devices keep priorities clearer between clinicians and their patients, whether used in person or virtually.

Providers can easily integrate clinical decision support tools into the patient visit — it’s not necessary to hide them out of sight. Patients typically appreciate when clinicians demonstrate that they are using the latest technology on their behalf. Mobile medical reference apps can be used in the exam room or at the bedside, so the clinician and patient can view the screen together to look at drug interactions, pricing information, and even side effects. Time spent using these resources and apps together can enhance the clinician-patient interaction.

The future role of mobile medical apps in supporting resiliency

It’s anticipated that clinicians will continue harnessing technology like mobile medical reference apps long after this global health crisis subsides, since they can be updated more rapidly than non-cloud-based electronic health records or typical institution-based reference resources.

During the current pandemic, a super-rapid updating pace is vital to combating the even faster, ever-evolving misinformation surrounding COVID-19. Mobile medical apps offer opportunities to increase clinician knowledge and productivity in real time. Expanded use of these technologies holds potential for improving clinicians’ experience of practicing medicine, expanding their skillsets, and ultimately enhancing the quality of care delivered to their patients.