Leverage Resources to Mitigate Physician Burnout

As an American Board of Dermatology Diplomate since 2011, I am a regular reader of Dermatology World. As a practicing board-certified dermatologist and President of Forefront Dermatology, the September 2017 cover story titled Feeling the Burn caught my attention as it listed sources of dermatologist burnout and mitigating strategies.

The common burnout drivers discussed in the cover story are all real challenges that I and my 125+ board-certified dermatologist colleagues see and feel in our practices each day – I get tired just listing the culprits: increasing regulations and paperwork, electronic medical records (EMR) impacting patient throughput, high patient demand in underserved areas, increasing patient expectations, and the hurdles, costs and challenges to prescribe medications, to name just a few. Whether you are a new or experienced physician, the effort required to manage and maintain, let alone grow, a practice today is significant and the environment is only increasing in its complexity.

At Forefront Dermatology, we have spent the better part of the last decade building a practice model to combat our environmental assault.


From inception, our Founder, Dr. Kenneth H. Katz implemented a service support system that was designed to allow our physicians to focus on our patients and delivering care, while a centralized support group tackled the evolving maze of requirements and complexity.

While no solution may be perfect, my extended support team problem solves and helps navigate day-to-day obstacles, lowering my stress and enabling me to be my best for my patients. My experience over the past 6 years has shown me the real operational and cost advantages of having our integrated, centralized support group under one roof.

Let me share with you some of the solutions that have been most effective in eliminating burnout burdens.

Contracting and Credentialing: Contracting and credentialing are fundamental functions that need to work well in order for physicians to treat patients and get reimbursed for patient care. Health plans have made this process difficult to navigate. Not fully grasping the continuous health plan process changes will likely lead to an inability to treat patients and subsequent delayed income. Thankfully, my colleagues and I have a contracting and credentialing team behind us who do the heavy lifting and communicate with us throughout the entire contracting and plan enrollment process.

Billing: Staying on top of any coding or reimbursement changes requires extensive journal research and subscriptions to the latest coding updates. Our billing team stays on top of any coding or reimbursement changes and works collaboratively with our physician leadership team to communicate those changes throughout the practice. Because of this support, my nights are spent with family rather than coding publications.

Regulatory Compliance: Understanding and staying on top of the mandatory government regulations is critical to your practice. Our legal and compliance team ensures that all government mandatory training is provided and keeps abreast of all regulations to keep us in good standing. Our team has been critically important over the past twelve months in preparing our entire practice for MIPS. They have rolled out physician training, modified our IT systems, and augmented the reporting to ensure compliance with all applicable measures, all while our dermatologists focus on patient care. I know other practices are relying solely on their EMR vendors; our assessment suggests this approach to be too superficial to meet the necessary measures. Without our legal and compliance team I would be overwhelmed trying to balance patient care with the time spent monitoring my achievement of these regulations.

Staff Recruiting: Growing practices have a constant need for finding, training, and retaining clinical staff to support the patient care. As a provider, I don’t have the time for this integral aspect of running a practice. Luckily, my colleagues and I have a full service human resources team tackling recruitment, training and benefits administration. When our physicians encounter performance or behavior deficiencies, we can choose to partner with our Human Resources team to resolve and manage to closure.

Marketing: Today, online reputation management is an increasingly important factor in generating new patient demand and patient decision making. Managing these reviews is a daunting task for a busy dermatologist. Thankfully, my colleagues and I have a marketing team that implemented a reputation management program to assist us in monitoring and improving our online reputation. Since implementing this program over eighteen months ago, our group has generated over 15,000 reviews and our physician average rating is now 4.8 out of 5 stars.

Measurement: Knowing where successes and shortfalls lie is critical in the success of a practice. Understanding what to monitor and how to improve is difficult when the primary focus should be on patient care. Our operations and analytics team developed a standard set of key performance indicators (KPI’s) that are used throughout the practice. This team reviews the data with our physicians and based on the physician’s request, they partner to identify actions to enhance the patient experience, reduce costs, improve efficiencies, and increase collections.

Technology: Lastly, as the physician leader for our practice, I regularly hear physicians complain about the impact that EMR has on their practice productivity and patient experience. While these concerns are relevant, we must accept the fact that EMR is not going away. I encourage my colleagues to find a way to optimize and integrate efficiently the use of EMR in their practices in order to support their practice objectives. A solution our practice has initiated for our dermatologists is a dedicated training team to assist our physicians and their staff in enhancing their use of the EMR in their practices complete with on-site training sessions, videos, and help desk hours.

While the Feeling the Burn article suggests we promote a more self-aware healthcare workforce, I am proud to be a part of an organization providing physicians with support we need to remain successful and provide high quality care, minimizing external pressures and ancillary duties. Forefront Dermatology has allowed my colleagues and me to effectively balance time between the practice of dermatology and our families, further minimizing the all too common physician burnout risk.