There are many advantages to being married to a doctor. For instance, when our son was a toddler and sliced through his tongue with his only tooth, my husband was able to call ahead to the Emergency Department and let his colleagues know I was headed their way. It was a good thing, too, since the sight of us both drenched in blood might otherwise have caused more panic than necessary—as it was, the ambulance driver that saw me park was so startled at our appearance he actually came to provide aid right there in the parking lot.
Health episodes aside, another benefit of having a spouse in the same field is that I often stumble upon really interesting articles that he is reading when I borrow his iPad. Recently, an article with the title, Physician Workload: Not Just a Residency Training Problem caught my eye.
The article is a review by Dr. Neil H. Winawer of a study published in JAMA Internal Medicine in January of this year. Researchers analyzed survey responses from over 500 hospitalists about the effects of physician workload. Most notably, “20% of hospitalists reported that increased workload led to unnecessary testing, delayed admission or discharge, and inability to discuss treatment options fully with patients and family members. About 20% also reported that their workload worsened quality of handoffs and patient satisfaction. Physicians estimated that they could see 15 patients per shift safely, provided they had no other responsibilities.”
While these results are not surprising, they are a stark reminder that all of the efforts underway across the state to eliminate unnecessary testing, fully engage patients in decision making, and improve transitions of care, might be completely undermined by an issue we may not be paying enough attention to: provider workload. The results also make me wonder about the additional impacts from overloaded providers on patients who are low-income or have complex medical, social, and emotional needs.
Colorado does have a Colorado Health Care Workforce Development Strategy. The document, written by staff at the Primary Care Office, includes very useful data and information but it is exclusively focused on primary care, including oral health, mental health and other therapies and services. This article, as well as many of my interactions with health care leaders across the state, point to the need for a much more robust dialogue about what is really needed for us to create a high-functioning health care system in Colorado.
Compassionate and skilled providers were there for my son and I when we needed them eight years ago. If we want to ensure that all people in Colorado can get high quality, effective health care when they need it, then there is an urgent need for a broader conversation about provider workload and workforce capacity. We must commit to taking care of the people who take care of us.