Clinicians at Physician-Owned Practices Have Greater EHR Satisfaction

EHR satisfaction is significantly higher among clinicians practicing at physician-owned practices than clinicians at non-physician-owned practices, according to a recent JAMA Network Open study.

In the cross-sectional study of 1,368 physicians, researchers from Brigham and Women’s Hospital examined the association between practice ownership and physician perception of EHR.

Nearly 59 percent of clinicians working at non-physician-owned practices were satisfied with their EHR, researchers reported.

Yet, EHR satisfaction was at 68.1 percent among those working in physician-owned practices.

In addition, researchers found that physicians working in physician-owned practices were more likely to have positive perceptions of time spent on documentation, and have staff support for documentation compared with their counterparts working in non–physician-owned practices.

However, the underlying workflow and cultural forces differences regarding how practice ownership impacts clinician satisfaction remain unclear, especially since EHR use is now widespread, the researchers mention.

The findings are particularly concerning given the fact that more physicians are working for practices not controlled by physicians, Richard J Baron, MD, the president and CEO of the American Board of Internal Medicine (ABIM) stated. Specifically, 70 percent of physicians work in non-physician-owned practices, Baron highlighted.

“The authors’ findings clearly suggest that a prevailing ownership trend may be a worrisome sign for the future of EHR satisfaction and rates of physician burnout, which makes it a matter of some urgency to understand what it is about physician practice ownership that could be associated with greater EHR satisfaction,” Baron wrote in an invited commentary regarding the study.

“Their findings about structural support suggest that simply providing more staff may be a good start, but it isn’t the whole story.”

Recognizing these factors contributing to less burnout and better satisfaction is important as physician burnout is directly related to EHRs. A 2019 study proved that EHRs contribute to approximately 40 percent of clinician burnout and stress.

“There is a well-documented association between EHR satisfaction and burnout, which is not surprising given how much clinical practice today is EHR-mediated practice, and every clinician is constantly interacting with an electronic platform to do almost anything they are trying to do with patients, not to mention documenting what it was they did,” Baron wrote.

The independence and autonomy clinicians have in these practices might offer protection against burnout.

Past studies have even suggested that clinician burnout could be decreased by enhancing provider autonomy, competence, and relatedness.

Providers in control of their own environment are able to recognize problems and address them as they wish, giving them a stake in the success of the EHR.

“If clinicians are able to exercise some measure of agency and control over how the EHR is used, to explicitly define some of the ways it can help them deliver better patient care, that could be an important principle of EHR use in large systems,” Baron said.

“Giving physicians some ability to redesign their workflows to assure that the right person is doing the right work is likely another important element,” Baron continued.