Exploring the administrative burden faced by hematologists: a comprehensive study in Italy
DOI:
https://doi.org/10.33393/grhta.2024.3042Keywords:
Administrative burden, Blood cancer, Burnout, Hematology, Oncology, SurveyAbstract
Background: Administrative burdens have been identified as a major issue impacting patient care, professional practice, and the overall efficiency of healthcare systems. The aim of this study is to assess the administrative burden faced by Italian hematologists.
Methods: A cross-sectional survey that included both closed-ended quantitative questions and open-ended free text answer options was administered to 1,570 hematologists working with malignancies and members of Italian GIMEMA Foundation – Franco Mandelli ONLUS and the Italian Linfomi Foundation (FIL). The survey was conducted online from May 24 to June 30, 2023. Descriptive statistics were computed for the quantitative data to clearly summarize the responses and descriptive analysis of free text responses was carried out.
Results: Surveyed hematologists spend an average of 47.07% of their time on administrative tasks, with 63.22% (n = 110) of respondents reporting spending at least half of their time on these activities. More than half (57.47%, n = 100) reported that “Patient care” is the medical task most affected by a lack of time. Additionally, 55.17% (n = 96) reported experiencing burnout in the past 6 months, with filling out “Forms” being identified as the top contributing administrative task by 27.59% (n = 48) of respondents, followed by “Scheduling” (24.71%, n = 43) and “Managing IT system failures” (21.84%, n = 38). Nearly half of the surveyed hematologists (45.40%, n = = 79) identified patient care as the top priority requiring more time.
Conclusions: The study confirms that the administrative workload of hematologists has a significant impact on patient care, communication, and burnout risk, reducing the time available for patient care, leading to exhaustion and concern about clinical errors.
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Erickson SM, Rockwern B, Koltov M, McLean RM; Medical Practice and Quality Committee of the American College of Physicians. Putting patients first by reducing administrative tasks in health care: a position paper of the American College of Physicians. Ann Intern Med. 2017;166(9):659-661. https://doi.org/10.7326/M16-2697 PMID:28346948 DOI: https://doi.org/10.7326/M16-2697
West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-529. https://doi.org/10.1111/joim.12752 PMID:29505159 DOI: https://doi.org/10.1111/joim.12752
Lee AI, Masselink LE, De Castro LM, et al. Burnout in US hematologists and oncologists: impact of compensation models and advanced practice provider support. Blood Adv. 2023;7(13):3058-3068. https://doi.org/10.1182/bloodadvances.2021006140 PMID:35476017 DOI: https://doi.org/10.1182/bloodadvances.2021006140
Weintraub AS, Sarosi A, Goldberg E, Waldman ED. A cross-sectional analysis of compassion fatigue, burnout, and compassion satisfaction in pediatric hematology-oncology physicians in the United States. J Pediatr Hematol Oncol. 2020;42(1):e50-e55. https://doi.org/10.1097/MPH.0000000000001548 PMID:31259831 DOI: https://doi.org/10.1097/MPH.0000000000001548
Bajwa NK, Singh H, De KK. Impact of EHR technology implementation on physicians’ job satisfaction. Int J Appl Manag Technol. 2019;18(1):11. https://doi.org/10.5590/IJAMT.2019.18.1.08 DOI: https://doi.org/10.5590/IJAMT.2019.18.1.08
Karsavuran S, Kaya S. The relationship between burnout and mobbing among hospital managers. Nurs Ethics. 2017;24(3):337-348. https://doi.org/10.1177/0969733015602054 PMID:26350707 DOI: https://doi.org/10.1177/0969733015602054
Murali K, Makker V, Lynch J, Banerjee S. From burnout to resilience: an update for oncologists. Am Soc Clin Oncol Educ Book. 2018;38(38):862-872. https://doi.org/10.1200/EDBK_201023 PMID:30231394 DOI: https://doi.org/10.1200/EDBK_201023
Hlubocky FJ, Taylor LP, Marron JM, et al. A call to action: ethics committee roundtable recommendations for addressing burnout and moral distress in oncology. JCO Oncol Pract. 2020;16(4):191-199. https://doi.org/10.1200/JOP.19.00806 PMID:32223701 DOI: https://doi.org/10.1200/JOP.19.00806
Rotenstein LS, Torre M, Ramos MA, et al. Prevalence of burnout among physicians: a systematic review. JAMA. 2018;320(11):1131-1150. https://doi.org/10.1001/jama.2018.12777 PMID:30326495 DOI: https://doi.org/10.1001/jama.2018.12777
Han S, Shanafelt TD, Sinsky CA, et al. Estimating the attributable cost of physician burnout in the United States. Ann Intern Med. 2019;170(11):784-790. https://doi.org/10.7326/M18-1422 PMID:31132791 DOI: https://doi.org/10.7326/M18-1422
World Health Organization (WHO). Burn-out an “occupational phenomenon”: International Classification of Diseases. https://www.who.int/mental_health/evidence/burn-out/en/. Accessed February 2024.
Hlubocky FJ, Back AL, Shanafelt TD. Addressing burnout in oncology: why cancer care clinicians are at risk, what individuals can do, and how organizations can respond. Am Soc Clin Oncol Educ Book. 2016;35(36):271-279. https://doi.org/10.1200/EDBK_156120 PMID:27249706 DOI: https://doi.org/10.14694/EDBK_156120
Shanafelt TD, Mungo M, Schmitgen J, et al. Longitudinal study evaluating the association between physician burnout and changes in professional work effort. Mayo Clin Proc. 2016;91(4):422-431. https://doi.org/10.1016/j.mayocp.2016.02.001. PMID: 27046522 DOI: https://doi.org/10.1016/j.mayocp.2016.02.001
Chen MA, Hollenberg JP, Michelen W, Peterson JC, Casalino LP. Patient care outside of office visits: a primary care physician time study. J Gen Intern Med. 2011;26(1):58-63. https://doi.org/10.1007/s11606-010-1494-7 PMID:20811956 DOI: https://doi.org/10.1007/s11606-010-1494-7
Sinsky C, Colligan L, Li L, et al. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med. 2016;165(11):753-760. https://doi.org/10.7326/M16-0961 PMID:27595430 DOI: https://doi.org/10.7326/M16-0961
Apaydin E. Administrative work and job role beliefs in primary care physicians: an analysis of semi-structured interviews. Sage Open. 2020;10(1). https://doi.org/10.1177/2158244019899092 DOI: https://doi.org/10.1177/2158244019899092
Braun V, Clarke V. Is thematic analysis used well in health psychology? A critical review of published research, with recommendations for quality practice and reporting. Health Psychol Rev. 2023;17(4):695-718. https://doi.org/10.1080/17437199.2022.2161594. PMID: 36656762 DOI: https://doi.org/10.1080/17437199.2022.2161594
Menon NK, Shanafelt TD, Sinsky CA, et al. Association of physician burnout with suicidal ideation and medical errors. JAMA Netw Open. 2020;3(12):e2028780-e2028780. https://doi.org/10.1001/jamanetworkopen.2020.28780 PMID:33295977 DOI: https://doi.org/10.1001/jamanetworkopen.2020.28780
Nguyen OT, Jenkins NJ, Khanna N, et al. A systematic review of contributing factors of and solutions to electronic health record-related impacts on physician well-being. J Am Med Inform Assoc. 2021;28(5):974-984. https://doi.org/10.1093/jamia/ocaa339 PMID:33517382 DOI: https://doi.org/10.1093/jamia/ocaa339
Downing NL, Bates DW, Longhurst CA. Physician burnout in the electronic health record era: are we ignoring the real cause? Ann Intern Med. 2018;169(1):50-51. https://doi.org/10.7326/M18-0139 PMID:29801050 DOI: https://doi.org/10.7326/M18-0139
Micek MA, Arndt B, Tuan WJ, et al. Physician burnout and timing of electronic health record use. ACI Open. 2020;4(1):e1-e8. https://doi.org/10.1055/s-0039-3401815 PMID:37800093 DOI: https://doi.org/10.1055/s-0039-3401815
Shanafelt TD, Dyrbye LN, Sinsky C, et al. Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clin Proc. 2016;91(7):836-848. https://doi.org/10.1016/j.mayocp.2016.05.007. PMID: 27313121 DOI: https://doi.org/10.1016/j.mayocp.2016.05.007
Tsai CH, Eghdam A, Davoody N, Wright G, Flowerday S, Koch S. Effects of electronic health record implementation and barriers to adoption and use: a scoping review and qualitative analysis of the content. Life (Basel). 2020;10(12):327. https://doi.org/10.3390/life10120327 PMID:33291615 DOI: https://doi.org/10.3390/life10120327
Dewa CS, Jacobs P, Thanh NX, Loong D. An estimate of the cost of burnout on early retirement and reduction in clinical hours of practicing physicians in Canada. BMC Health Serv Res. 2014 Jun 13;14:254. https://doi.org/10.1186/1472-6963-14-254. PMID:24927847 DOI: https://doi.org/10.1186/1472-6963-14-254
Canadian Medical Association 2021 National Physician Health Survey. https://digitallibrary.cma.ca/viewer?file=%2Fmedia%2FDigital_Library_PDF%2F2021%2520NPHS%2520report%2520EN.pdf#page=1. Accessed February 2024.
Roberts DA, Faig J, Bodio-Downey K, et al. Training hematologists/oncologists for the academic-community hybrid: creating a fellowship framework for the future. JCO Oncol Pract. 2023;19(6):e927-e934. https://doi.org/10.1200/OP.22.00671 PMID:36534931 DOI: https://doi.org/10.1200/OP.22.00671
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Accepted 2024-06-12
Published 2024-07-03
