Preparing for Quality Talks, we interview our scheduled speakers to, so we can provide you. Your job in all this, is of course, is to take a closer look and register. Registrations for online attendance are going fast.
So, check out our discussion with Peter Yellowlees, MD, Chief Wellness Officer at UC-Davis Health in Sacramento. You’ll see, he’s an agent of change. Just what we like at Quality Talks.
NCQA: It’s your dual interests that attracted our Quality Talks team to your work.
Yellowlees: I guess my interests are primarily in two areas.
I’m really interested in how you use technology to provide better patient care, better access to care in particular. And then I’m also interested in how we actually look after ourselves—as providers, as physicians, nurses and other clinicians.
I’m a practicing psychiatrist. Most of my patients are physicians. I’ve become increasingly interested in the issue of burnout and in particular how we can combine my two interests to look at how we use technology intelligently so that we as doctors, work better, feel less anxious, to feel less burn out and actually provide better care.
NCQA: And If you if you treat mental health issues for physicians, you’re actually treating their patients in some way. Isn’t that true?
Yellowlees: I think that’s exactly right. I know that if I can keep one physician working well, then I’ve got another maybe a thousand or fifteen hundred people that are at least partially dependent on that individual. So, I see myself and my interests in physician well-being, as something that really is amplified in terms of patient care around the community.
NCQA: Coronavirus. You’re seeing something out there on the West Coast that I think probably all of us will see more of, and very soon. I know everyone in health care is working on prepping and trying to avoid panic. But isn’t this also added stress for doctors, certainly more time and more work.
Yellowlees: I think the pressure on doctors, nurses and other professionals is primarily the potential fear of becoming infected and potentially seriously ill. Having said that, you know, it’s a virus. It’s serious, but there’s no reason to panic and no reason to change our normal workflows. But we have to be very aware of the potential for infection and the potential for us, as health care professionals, to contract it.
NCQA: So, even before coronavirus, we expected you’d discuss burnout and efforts to mitigate it. How serious of a crisis is it for physicians? There are, I believe, alarming suicide rates among physicians.
Yellowlees: We estimate that about 400 physicians per year in the United States suicide which is equivalent to two large medical school classes. That’s obviously, you know, a really very major problem.
And I guess I see that physician suicide rate and the high rates of burnout in physicians really acting like canaries in the coal mine. There are people who are showing distress as a consequence of a disorganized and dysfunctional healthcare system.
I think what we’ve got to really look at is, how do we deliver health care better so that physicians and other health providers are less stressed and feel better about what they’re doing. I can think of no one who went to medical school to spend several hours a day working on a computer.
NCQA: It’s hard, right, because generally people go to med school to help other people. Then they get to be doctors and quickly find out, wait I’m running a business here, but I don’t really feel like I’m helping people.
Yellowlees: I think that’s true. I mean, what we know about physicians is that on the day they enter medical school, they’re actually more resilient and less depressed than the
average equivalent graduate student who is not going to medical school. Yet within literally two years of going to medical school, physicians are significantly more burnt out and depressed.
We’ve got to change the system. We’ve got to allow physicians to use their natural inborn resilience, and to not become disaffected with the amount of administrative burden many have. And allow physicians to get back to spending more time with patients and doing what they actually went to medical school for.
Adapt to Change Early, Often
NCQA: Does that include changing the way we prepare med students for practicing medicine?
Yellowlees: It certainly does include medical school. In fact, in my role as a chief wellness officer, I’m very involved in trying to make changes within our own medical school, and more broadly.
The NBME (National Board of Medical Examiners) has just made a really important change and decided that it’s going to change the way that it scores, and move to a pass-fail process rather than a numeric score. That’ll take an enormous amount of pressure off medical students in the first couple of years of school. So that’s a really positive change.
But essentially what we need to understand about medical school is there’s too much information in medicine. You can’t possibly learn everything. Most people equate going to medical school as sitting in front of a firehose turned on for four years. You can’t take in that amount of information. What we have to do is to teach people how to learn, how to keep up to date, how to be critical and how to make decisions. We have to accept the fact that the data they are using, the actual information about patients and health care, will be constantly changing through their careers.
NCQA: The constant change can be overwhelming. So, teach them to adapt to the changes and consult the resources as much as they can.
Yellowlees: That’s exactly right. The term commonly used is change toxicity. That’s particularly the case with electronic medical records. These are highly complicated pieces of software. We don’t tend to get a lot of training on them. They’re constantly updated. Often—on a Monday morning, maybe a couple of times a year—I suddenly find out the main tool I’m using for all my documentation looks completely different. These are things that are hard to adapt to. So, we’ve got to look at how do we train people to be able to adapt more easily to the constant changes that occur.
And in particular, also look at how to use technology intelligently with our patients so that we both save time and are more flexible in the way we work. We traditionally expect for a patient to always physically come and see a doctor in their clinic. That’s really not always appropriate. And certainly, people like myself increasingly are doing home visits via video. That’s much more convenient for patients and for myself.
NCQA: And spreads you a little further without taking a whole lot more time.
Yellowlees: In many cases it’s much more efficient. I mean what I try and do is see more patients perhaps less frequently, doing more consulting working in teams, typically with primary care physicians and their associates. Spreading my skills further using technology.
NCQA: So, I’m a prospective audience member. Tell me why I want to see Peter Yellowlees speak at Quality Talks?
Yellowlees: So what you want to know is how a practicing physician like myself actually provides care using technology in a way that is less stressful to me and more acceptable to my patients.
NCQA: That’s a nice summary, Doc. I appreciate it. Thank you.
Matt Brock is the Director of Communications at NCQA. After more than two decades working in broadcast journalism, Matt now leads NCQA’s efforts to develop unique content that engages and informs consumers as well as providers, plans and policymakers via this blog, our website, NCQA.org and numerous social media platforms. Matt’s goal is to educate consumers and to direct them to the best resources when considering quality in their health care decisions.