As just about everyone knows by now, perhaps the most frequently discussed topic in health IT circles for the past year has been how electronic health records (EHRs) and other technology have contributed to physician burnout. This has been a major area of concern from the federal government all the way down to the physician practice level.
At the core of many of these conversations is the Englewood, Col.-based Medical Group Management Association (MGMA), an industry association with a membership of more than 40,000 medical practice administrators, executives, and leaders. As Halee Fischer-Wright, M.D., president and CEO of MGMA since 2015, explains, MGMA once had a reputation for being an association that represented small practices only, but the current trend is that the membership’s average practice size is actually what’s defined as “large physician practices” across the U.S. Fischer-Wright notes that MGMA’s membership base is now 50 percent larger systems, 30 percent larger practices (meaning 100 or more physicians), with the remaining 20 percent smaller practices, meaning less than six full-time physician FTEs. Says Fischer-Wright, “There has been a significant shift” in our membership.
Fischer-Wright is a nationally recognized healthcare executive and a physician leader. In her new book, Back To Balance: The Art, Science, and Business of Medicine, She describes the crisis American healthcare is in—with the average American physician spending two hours on paperwork for every hour spent with patients; with one in twenty patients being misdiagnosed daily; and with only thirty-four percent of Americans expressing “great confidence” in the leaders of the medical profession.
To this point, a very recent MGMA survey found that medical groups are increasingly feeling the pressure of regulatory burdens, with the vast majority of physician practices finding it difficult to comply with the Merit-Based Incentive Payment System (MIPS) under MACRA (the Medicare Access and CHIP Reauthorization Act of 2015). The survey had some startling findings, perhaps most notably that 82 percent of medical practices identified MIPS as “very” or “extremely” burdensome; and that nearly half of respondents reported spending more than $40,000 per FTE physician, per year to comply with federal regulations.
Fischer-Wright recently spoke to Healthcare Informatics about these physician burden issues, what possible solutions might be, and other healthcare challenges that MGMA’s membership are facing. Below are excerpts of that discussion.
Halee Fischer-Wright, M.D.
I’d like to start with a personal question since your career has been so fascinating. How have your past endeavors led to becoming CEO of MGMA?
I have had a diverse career; I never exclusively practiced medicine. I started my own practice with a partner when I was 29 and I as there for 19 years. During those years I also functioned as a practice management consultant, and I was president of a large physician group for 14 of those years. I was also a management strategy leadership consultant in many other industries other than healthcare during that time. And I was also a chief medical officer for two years prior to my role at MGMA. So I would best describe my career as asynchronous. It’s with that diversity of perspective when the opportunity came to apply for the CEO of MGMA, the broad experience I had—including in non-healthcare sectors, like financial services, real estate, oil and gas—gave me a unique view on the role.
What do you see as healthcare’s greatest challenge today?
Our biggest challenge right now, and you see this playing out in the political landscape regardless of what side of the fence you are on, is we’re seeing people becoming aware that healthcare—which was always assumed as something that people purchase—is something that’s a societal need. What we see in the political landscape right now is that while we may not support this or that policy, the idea that there might be [so many] people who might not have health insurance is undesirable regardless of what side of the fence you are on. I think that will force rapid change. Healthcare has been in a transition in the last 5 to 10 years at a high velocity, but I think this will help us completely rethink how we approach healthcare from a policy and economic standpoint. So we have only begun to take on the upheavals that lay in front of us.
We have been hearing a lot about physician burnout and specially the burden that IT puts on doctors. What’s your take on how burdensome EHRs can be?
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