Utilization management tactics used by insurance companies can have detrimental effects on patient care, a study recently published in The American Journal of Managed Care found.
The national poll of 501 physicians across the United States shows an alarming link between utilization management and physician burnout. Tactics such as prior authorization, step therapy and non-medical switching, the survey reveals, can lead to decreased quality of patient care, worsening physician shortages, and poor physical and mental well-being for physicians.
The Burden of Utilization Management
Surveyed physicians reported that:
- (95%) Utilization management complicates treatment decisions.
- (90%) They enjoy their job less because of utilization management.
- (2/3) They’ve experienced burnout at some point in their career.
Utilization management takes the focus away from patients, wasting physicians’ time and staff resources. Rather than determining what treatment plan is best for an individual patient, physicians must consider insurance companies’ utilization management restrictions and protocols, limiting their ability to provide optimal care.
The Effects of Burnout
As utilization management burdens physicians and negatively influences their feelings about work, it leads to job dissatisfaction and burnout.
- 94% of physicians agreed that burnout can decrease the quality of a patient’s care.
When physicians experience burnout, they undergo emotional exhaustion, a lack of enthusiasm, decreased satisfaction and physical exhaustion, the survey found. Burnout symptoms can have drastic consequences on the entire health care system.
- 64% of physicians experiencing burnout considered leaving their profession.
- 97% of physicians agreed that burnout could worsen physician shortages.
At a time when physician shortages affect nearly every specialty, burnout is a leading reason why doctors leave the profession.
Enacting Change
Poll responses made it clear that policymakers must with urgency curb the effects of utilization management.
- 97% of physicians believe treatment decisions should be fully restored to providers and patients.
Excessive utilization management practices direct physicians’ attention and resources away from patient care. By taking action to curb these practices, policymakers can remove a significant contributing factor to physician burnout, improving care and quality of life for physicians and their patients.