Utilization management and physician burnout

• Published in: The American journal of managed care 2024-11, Vol.30 (11), p.561-566
• Main Authors: Struthers, Arwen, Chapman, Mary Ann, Charles, P David, Conschafter, Amanda, Cooper, Josie, Clingham, Gavin
• Format: Article
• Language: English
• Subjects: Access to information; Adult; Burnout; Burnout, Professional - epidemiology; Capitation; Data collection; Demographics; Dermatology; Endocrinology; Family physicians; Female; Gastroenterology; Health care policy; Humans; Male; Medical errors; Medicine; Middle Aged; Ophthalmology; Otolaryngology; Patients; Physicians; Physicians - psychology; Physicians - statistics & numerical data; Quality control; Rheumatology; Surveys and Questionnaires; United States; Urology; Working groups
• ISSN: 1088-0224; 1936-2692; 1936-2692
• DOI: 10.37765/ajmc.2024.89626

This study was designed to assess physician experiences with utilization management and burnout and investigate whether they are linked. We conducted an electronic survey with items related to demographics, profession, utilization management, burnout, and potential policy solutions. The survey was sent to 7222 physicians working in outpatient settings who were recruited from a large, opt-in database. Outcome measures were responses to categorical and Likert-style survey items related to demographics, utilization management, burnout, and potential policy solutions. Of 7222 requests sent, 501 physicians completed the survey and were included in the final data set (77% men; mean [SD] age, 57 [9.8] years; mean [SD] years in practice, 24 [8.9]). Of these, 200 were general practitioners and 301 were nonhospital specialists. Physicians indicated that utilization management procedures for prior authorization (81%), step therapy (79%), and nonmedical switching (69%) were major or significant barriers to their clinical and patient care. More than half (52%) reported spending 6 to 21 or more hours per week on paperwork related to health insurance utilization management, 67% had experienced burnout at some point in their careers, and 64% indicated that utilization management had been a contributing factor to feelings of burnout, with an additional 8% citing it as the main factor. Physicians favored streamlining prior authorization practice (77%), requiring step therapy to be based on science (73%), and ensuring that peer-to-peer reviews are done by qualified medical experts (67%). These findings indicate that utilization management has a detrimental impact on physicians and patient care and contributes to physician burnout.