Quadruple aim hinges on solutions
“Although detrimental to the well-being of physicians, professional burnout is also associated with lower patient satisfaction, increased medical errors, poorer health outcomes and higher health care costs,” wrote the authors, Andrew J. Jager, Michael A. Tutty, PhD, and Audiey Kao, MD, PhD. Jager and Dr. Kao work in the AMA’s Ethics Standards Group, of whom the latter is vice president. Tutty is group vice president of Professional Satisfaction and Practice Sustainability at the AMA.
“Given the significance of outcomes linked to burnout, promoting physician wellbeing is seen as an essential element of successful health system transformation, leading some to refer to a quadruple aim that explicitly recognizes the need for physician and care team well-being,” they added.
With passage of the Medicare Access and CHIP Reauthorization Act of 2015, the authors noted, the health care system is poised for transformation, so the time is right to implement system-wide changes that advance the goals of the quadruple aim. At the 2016 AMA Annual Meeting, the House of Delegates adopted policy on the quadruple aim, adding “the goal of improving the work-life balance of physicians and other health care providers” to the existing triple aim of improving population health and patients’ care experiences while cutting per capital health care costs.
Support at the policy, practice, personal levels
The AMA also has policy encouraging further studies and disseminating the results of studies on physician and medical student burnout to the medical education and physician community. AMA policy supports programs to assist physicians in early identification and management of stress, focusing on the physical, emotional and psychological aspects of responding to stress in physicians' professional and personal lives, as well as when to seek professional assistance for stress-related difficulties.
In addition, the AMA last year adopted policy supporting strategies to destigmatize mental illness and enable timely and affordable access to mental health services for undergraduate and graduate students. It also supports collaborations among university mental health specialists and local public or private practices to provide a larger pool of resources, “such that any student is able to access care in a timely and affordable manner.”
The AMA’s STEPS Forward™ collection of practice improvement strategies helps physicians make transformative changes to their practices. It offers modules on preventing physician burnout in practice, preventing resident and fellow burnout and improving physician resiliency.
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- Cleveland Clinic’s approach to burnout focuses on relationships