Physician Burnout - don't let ICD-10 be your tipping point

Posted by Dike Drummond MD

emr-strategy-icd-10-physician-burnout_opt150wPhysician Burnout - don't let ICD-10 tip you over the edge

There are plenty of signs that a significant number of physicians are walking on the edge of a cliff at work. If you look at this year's Medscape Physicians Lifestyle Survey, 46% of those 19,000 doctors are already suffering from burnout symptoms. Even more are on the verge.

Will ICD-10 be the tipping point in your practice?

Experts tell me that ICD-10 could mean an hour or more extra work in your day starting October 1st. I am very suspicious you don't have that kind of time just lying around in your practice.

In this post I will show you why I think ICD-10 may be the tipping point for many physicians - and what you can do now to avoid that fate.

==========  CLICK HERE for our 6-Part EMR streamline strategy a FREE chapter download from "Stop Physician Burnout" ==========

Walking the edge of the cliff

physician-burnout-icd-10-last-straw_opt-300wHere is the relationship between stress and productivity. It is a classic bell shaped curve.

- You need some stress to be productive
- There is a zone of optimum productivity - here in gray
- If you go beyond that, productivity falls dramatically and symptoms of burnout intervene

Are you on the edge?

The orange line on this version of the stress vs productivity graph is where many doctors sit now. Hopefully that is not you. You can see it does not take much to push you over the edge.

What about ICD-10?

I have interviewed several ICD-10 implementation consultants recently on the additional time it will take the average doctor to deal with ICD-10 's and their answers are downright scary.


ICD-10 Highlights
- Expands the ICD-9 code set of 14,000 to 68,000
- ICD-9 is 3-5 digits
- ICD-10 is up to 7 digits including ones for severity, location and cause


Here is the bottom line

 ...up to an additional hour a day for the average doc to find the correct ICD-10 codes

That's what the experts are telling me:

Here is what I learned from Stuart Newsome, VP at Alpha II ( ) a publisher of coding books and revenue cycle software including Alpha II Code Search and Code Wizard products. NOTE: I have no financial relationship with Mr. Newsome or Alpha II.

In order to code accurately in an ICD-10 universe you will need to master whatever software your EMR uses to look up the new codes. That's right - learn to use new software and algorithmic search tools. You can't flip through a book and look these codes up manually. 

If you code your own charts, this will take 1-3 minutes extra (and more) per patient - at least for the first couple of months until you get used to the new ICD-10 system.

If you see 20 patients a day ... that is 20 - 60 minutes extra on your charts that will start on 10/1/2015

NOTE: If someone else codes for you using your chart notes ... you are almost certainly in much bigger trouble ... here's why

Your current dictation does not give your coder the amount of information they need for an ICD-10 world.

They are going to be bringing multiple charts to you every day for clarification on the details they need to assign the complete and accurate ICD-10 code. What a pain. 

I predict this is going to push a lot of doctors right over the edge and into physician burnout

Let's make sure you are NOT one of them !


What can you do to prepare ?

FIRST, learn everything you can about ICD-10 and how it will be implemented within your EMR in your practice.

- Create your own ICD-10 implementation action plan

- Get with your IT team and EMR vendor and take the trainings on ICD-10 ASAP so you are ahead of the curve.

- Make your cheat sheet of most frequent codes. Remember to include the new severity, location and cause modifiers

- Master the ICD-10 lookup software that will be built into your specific EMR program for the patients who don't fit into your hot list. Know how it works and the quickest path to a final answer.

- If someone else codes for you, learn the specific severity, location and cause requirements for full coding. Start adding them to your routine dictation habits now.

Most importantly - streamline your documentation process ahead of ICD-10 so there is room in your day on October 1st

Since ICD-10 is unavoidable, the key here is to make room in your documentation routine NOW.
- ICD-10 has a learning curve.
- It will slow everyone down for at least several months
- But that does not have to push you over the edge and into physician burnout.

What can you do about your charting process now that will free up the time and energy you will need for ICD-10 when it hits?

Here are several specific recommendations we have tested in hundreds of physician practices in all specialties. 

physician burnout bookDownload our six-part EMR Strategy - a FREE Book Chapter - and get started today

- Learn why EMR is not a problem ... hint: it's a Dilemma
- Learn a field tested, six-part EMR strategy to create the space in your day for ICD-10 and even get you home sooner
- Make room in your day for ICD-10 BEFORE it hits so you and your family do not suffer the consequences

==========  CLICK HERE for our 6-Part EMR streamline strategy a FREE chapter download from "Stop Physician Burnout" ==========



What is the biggest challenge you face with documentation?
What impact do you think ICD-10 will have on your practice?


Tags: Physician Burnout