Tuesday 2 November 2021

We are Asking Our Physicians to Do Too Much. It’s No Wonder They are Burnt Out.

By GAIL PEACE

We have heard the phrases “physician fatigue” and “burnout” too often in the last year – and for good reason. Covid-19 has placed an incredible burden on our healthcare providers. However, as healthcare professionals, the stats representing physician burnout are not new for us.  

We have seen similar trends and stats for years. Covid-19 did not cause the current state of physician burnout, it has just exacerbated it and further exposed critical issues with the expectations placed on physicians in today’s healthcare system. Ludi conducted a survey of physicians across the country confirming that exact theory:

  • 68 percent of physicians feel pessimistic or indifferent about their occupation
  • 48 percent describe the relationship with their hospital partners/employers as combative or transactional at best

We need to ask ourselves: What is actually causing this dissatisfaction and how can hospitals better align with their physician partners?  

According to the physicians surveyed, 68 percent agreed they have too much administrative burden placed on them. More often than not, our industry blames EHRs for dominating administrative time, but from the physicians we surveyed, EHRs are just part of the problem. In fact, 54 percent of physicians indicated they spend 1-3 hours per day on administrative work outside of EHR time, with another 35 percent spending more than 4 hours per day on similar tasks.

Let’s put that into perspective. On top of seeing patients, charting in EHRs, and all the other things physicians are expected to do to take care of patients, physicians are also spending at least another 1-3 hours per day on “everything else.” This everything else includes meetings, training, compliance, policy, etc.  

We are asking our physicians to do too much. It’s no wonder they are burnt out.

SOURCE OF DATA: Ludi Inc. compiled data on administrative work performed by more than 1,200 physicians between May 2020 and May 2021 that was logged through Ludi’s DocTime™ Suite. The notes entered directly by physicians represent how physicians spent their time for the last year when they weren’t seeing patients – as depicted in the word cloud. 

To better align with physicians, hospitals need to empower physicians to focus on what they do best and appropriately pay them for that work.

SOURCE OF DATA: Ludi, Inc. surveyed 100 random physicians in the United States currently employed by a hospital or a medical group or independent physicians contracted with a hospital.

The numbers speak for themselves and the ball is in the hospitals’ court to work with physicians to help them focus on patient care. In response, we are already seeing unprecedented levels of compensation redesign across the industry to better align physician and hospital priorities.  But these comp redesigns are just part of the solution. There’s plenty of low-hanging fruit that hospitals can leverage to improve their physician relationships right now – and it all starts with reducing administrative burden. 

First, hospitals should consider how and where technology can be used effectively within the nuances of their operations. They can start by asking themselves a few key questions, such as: Are there tasks or processes physicians are doing on paper right now that could be automated? What does this manual process involve and how does it impact different departments? What are the most time-consuming tasks for physicians each day, each month?

Of course, hospitals should also make sure the reason they’re implementing new automation in the first place is clear to them. That is, they should be solving for specific pain points (and agree on the priority of those pain points), and with direct feedback from the stakeholders themselves, in this case, physicians. If a hospital implements a solution that doesn’t take into account the physician’s daily routine or workflow, then it’s likely the new automation will fail. And when you’re dealing with doctors, you want to make the solution is as easy and quick as possible, given everything else they have to deal with throughout the day. 

The fact of the matter is though, when it comes to automation technology, more than 83 percent of physicians we surveyed agreed automation technology focused on reducing administrative workloads will improve their productivity and job satisfaction. That’s good news for hospitals.

Why? Because the less time physicians are spending on administrative tasks means more time spent with patients and other more meaningful tasks. And that’s a win-win for everyone. 

At the end of the day, hospitals should always be focused on what else they can do to support their employees from a morale perspective. I worked for health systems where we had an option to drop off dry-cleaning in the lobby – a simple task but something that physicians may not have time for given their demanding schedules. Now, take that example, apply it to the big picture, and go for it.

So, what are you waiting for?

Gail Peace is founder and CEO of Ludi, Inc., a health care technology company making it easier for hospitals to pay physicians.


We are Asking Our Physicians to Do Too Much. It’s No Wonder They are Burnt Out. posted first on http://rehabitation.blogspot.com

#Healthin2Point00, Episode 239: Hinge, Femtec, Science37, Augmedix

On a special Saturday edition of Health in 2 Point 00, Jess and I talk about her amazing forecasting and the huge scale of one deal. Yes, the Tiger pounces and Hinge Health takes its total raise to $1 billion. There’s also an complex combo deal for Femtec, raising $38m buying Birchbox and more, and we give a quick mention to the brief history of public companies Science 37 & Augmedix – Matthew Holt


#Healthin2Point00, Episode 239: Hinge, Femtec, Science37, Augmedix posted first on http://rehabitation.blogspot.com

Thursday 28 October 2021

#Healthin2Point00, Episode 238 | Trupill, Stride Health, Bardavon, and Wider Circle

Today on Health in 2 Point 00, Jess and I talk about the importance of a good company name. Some deals today: Truepill gets 142 million in a Series C bringing their valuation to 1.6 billion with 300 million ARR; Stride Health gets 47 million gets, bringing up their total to 86 million; Bardavon Health Innovations gets 90 million, bringing their total up to 109 million; Wider Circle gets 38 million, invested in by AmeriHealth Caritas. – Matthew Holt


#Healthin2Point00, Episode 238 | Trupill, Stride Health, Bardavon, and Wider Circle posted first on http://rehabitation.blogspot.com

Godwin’s Law and the Rise of Hyperbole on MedTwitter 🙄

By @roguerad

I first clashed with authority when I was eight. Every Saturday bunch of brown kids, children of Indian immigrants to Britain with an identity crisis who longed for the culture they left behind, attended a class in the temple about “our culture” taught by a joyless scholar of Hinduism – a pundit – whose major shtick was punctuality. When I turned up late, even by a minute, he’d make me stand outside, even if freezing. Some kids called him “Hitler,” or “Hitler uncle,” the qualifier “uncle” indicated that because he was as old as our fathers, he deserved respect. 

Then, I believed that Hitler meant authority. I preferred calling the pundit “wanker” or “asshole” but the foul language would have gotten me afoul with my parents, my authority figures. “Hitler” amply conveyed disdain for our pot-bellied teacher who exercised his authority whenever he could, without tarnishing our nubile vocabulary.  

Eventually, I understood the significance of Hitler, and of World War 2, the Nazis, and the Holocaust. Though related neither morphologically to the perpetrators nor ethnically to the victims of this ghastly period in human history, I developed a reverence, a sensitivity if you will, to such allusions. The Lord of the Old Testament instructed Moses that his name be not used in vain, lest every blocked sink or traffic jam evoked “oh my God.” I resolved never to use Nazi as an epithet frivolously. 

I was surprised how common Nazi name-calling was in American political discourse across the political spectrum, which peaked during the Trump Presidency. Some likened migrant detention facilities to “concentration camps.” Many saw in the rise of white nationalism during Trump’s reign parallels with the Third Reich. The former White House strategist, Steven Bannon, was compared to the Nazi propagandist, Goebbels. Bannon is loathsome, detestable, a wanker. Goebbels is a mass murderer – no adjectives are needed to describe him further. 

Since the pandemic, hyperbole has become the Lingua franca of the medical community. COVID-minimizers have “blood on their hands.” Lockdowns are fascist. Misinformation kills. Peddlers of misinformation are “mass murderers” and COVID skeptics “enable” the murders. The average citizen has the ignoble choice between fascists and mass murderers. The twist is that fascists can become mass murderers and mass murderers can become fascists. 

We’re drowning in hyperbole. Mask mandates have been compared to women forcible veiled by the resurgent Taliban. Childhood masking has been likened to child abuse. On a related note, Richard Dawkins, the author of God Delusion, was my intellectual hero for his articulate scientific atheism, until he said that teaching children religion is child abuse. The line between being peak wisdom and deep absurdity is thin. I’m no fan of God, but comparing compulsory Church attendance to child abuse is moronic.  

Even close scientific debates such as the net societal benefits of vaccinating teenagers are refereed by hyperbole. Skeptics of universal vaccinations are called “immoral. The skeptics, in turn, believe they’re truth warriors facing persecution, like Galileo, Semmelweis, and Kepler. Galileo, thrown in a cold, rat-infested, prison, was stopped from throwing his toys off the Leaning Tower of Pisa. Modern-day heretics get ratioed – this is when random people are drawn to your provocative tweet like horse flies to fresh excrement. Your notification box explodes and you’re subjected to repetitive dull, righteous, scolding from a herd of mirthless dimwits. Having been ratioed a few times in my illustrious Twitter career I can attest that it’s not fun. My thumbs hurt. I feel helpless as the pile on accrues. And my wife yells at me for being glued to my phone. As unpleasant as that is, I don’t think it’s the same as Torquemada pouring molten oil on your gonads for heresy. I’ll take incivility over death, thank you. 

We’re supposedly in an age of censorship. Scientific discourse has never been in more danger. Yet the channels for bloviation have never been more abundant. Anyone can have a podcast or a Youtube channel, and many do. For every podcast you’re aware of there are ten thousand you have never heard about. Then there’s Tik Tok where you’re allowed 90 seconds of incontinent self-expression. That Tik Tok, which has enriched itself on capacious American “me”ness, is Chinese-owned is delightful irony. Everyone fancies themselves as entertainers, Socrates, Galileo, Gandhi, Keats, Orwell, and their opponents as Nazis or morons. If greatness has been democratized, evil has become plebian. 

If science is being censored it’s not being censored by authority, but noise. There is too much nonsense everywhere. The great poet Ovid was banished from Rome. The e-Ovids are muted or blocked on Twitter and banished from by-invitation-only echo chambers. Discourse is dead because it’s hard distinguishing between the good faith interlocutor and the troll. Even the sincerely curious can get tedious. It’s also hard to be convinced of anything when everyone around you is trying to convince, rather than be convinced. Too many teachers, not enough students. Everyone is hectoring. 

More ominously, there are campaigns to get you fired for expressing views the noisy, energetic, minority don’t like. Employers, particularly corporations with overpaid PR personnel with too much time on their hands, petrified of bad press on social media, reprimand offenders using a mix of good old-fashioned scolding – the sort your parents dished out for telling Auntie Indu that her cooking was awful. And detention. Not the Breakfast Club type of detention – that’d be too much fun. Nowadays detention means taking online modules on empathy and sensitivity.  

Once, someone complained to my employer. I had used an unflattering adjective to describe him. I said “twit,” or “tosser,” I can’t recall. But it was considered “unbecoming of a steward of such a great institute” (his words, not mine). The media department asked me to declare in my Twitter bio that my adjectives were my own. I wrote, “my employer’s views don’t reflect mine.” Our discomfort was mutual. But what the incident showed me is that our greatest enemy isn’t a Stalin-style tyrannical government, but each other. 

We’ve always been petty, self-centered, sensitive, with an overgrown sense of self-importance. And nasty. Social media has scaled our nastiness. The KGB (*) through its labyrinthine auditory network was a patch on the screenshots offered by products of capitalism. Post a screenshot of a passionate conversation you had with a drunk friend with a command of Punjabi expletives, five years after the conversation, just as your estranged friend is about to ascend the pinnacle of their career. As long as you don’t post the post-hangover apology the next day, you could ruin their career. That’s the power we have over each other. We truly are our brother’s keepers. 

Maybe everyone will have their fifteen minutes of shame. Incidentally, an old friend who used to DM me ten times a day suddenly stopped. I asked why. She was concerned that because I was a “high-profile personality,” my phone might be hacked and our conversation leaked to Twitter. I know you’re chuckling at me for falling for an imaginative excuse of the “dog ate my homework” genre. But it sounded imminently plausible.   

Hyperbole is endless. Mike Godwin coined Godwin’s Law, which is that the longer an argument on the internet proceeds, the more likely someone is going to make a Nazi analogy. Having been in a few internet arguments I understand the exasperation of fighting strawman arguments and misrepresentations – the frustration of not being able to convince or be convinced. Ideally, you’d end the argument graciously with “let’s agree to disagree” or “at least we agree that Philadelphia Eagles will blow it again.” But the frustrated internet warrior loses goodwill. When you call your opponent a Nazi you’re really saying the topic is beyond debate and your opponent is immoral. You might as well say “whatever.” Or “moron,” if you’re less charitable. 

Recently, Twitter celebrity physician, Vinay Prasad, warned that the pandemic is ushering dark days for democracy. He was concerned that over-zealous public health measures, egged on by a scientific community with the credentials to alarm the proletariat, could lead to such abundant state power that it could lead to fascism.. He likened our present to the brewing storm in the early days of the Third Reich. Prasad was ratioed. He was accused of insensitivity, historical ignorance, and sensationalism. Many asked his employer to fire him for comparing our public health measures in the pandemic to Nazism.

Aside from the historical inaccuracy, my major problem with Prasad’s thesis was its unoriginality. Et Tu Prasad? Nazi comparisons are dime a dozen. Anything can be a short step to Nazism. Bioethicist and Holocaust expert, Arthur Caplan, called Prasad’s essay “imbecilic, ignorant, and dangerous.” My preferred terms would have been “impetuous” and “disillusioned.” Prasad feels disillusioned by the response to the pandemic which he believes has worsened the disparities he has spent his life fighting to reduce. Whatever the merits of his disillusionment, as one can rebut that it’s the virus that worsened the disparities not the response to it, Prasad is principally guilty of the naiveté of a true believer. I never saw the purity of progressivism that Prasad bucolically recalls. Progressivism always seemed an expedient mix of opportunism, careerism, and hypocrisy, which is how it got stuff done. 

Multiple factors led to the rise of Nazis, notably anti-Semitism. The anti-Semitism didn’t arise overnight. It took centuries to perfect. Which is why Hitler could persuade Pope Pius Pacelli XII to persuade the Christians in Germany to vote for him. The deeply flawed Pope saw in Hitler an opportunity to avenge Jesus of Nazareth’s crucifixion. The frivolous comparisons of any polity we dislike to Nazis reeks of historical ignorance. History is complex. Holocaust was a culmination of historical evil. As Sven Lindqvist argues, the holocaust was the sequel to the African genocide by the European colonialists, notably Belgium’s King Leopold.

To believe that mask and vaccine mandates could lead to the same eventuality as the German hyperinflation caused by the Treaty of Versailles betrays an alarming level of judgment. It is, however, merely a sign of our times where hyperbole is the language of public discourse. Thus, the frivolity with which Nazi comparisons are made is reflective more of our exasperation than anti-Semitism. I disagree with Caplan. I have no doubt that Prasad is in no way anti-Semitic. Accusing him of anti-Semitism devalues the gravity of the charge. In fact, Prasad is likely fervently anti-anti-Semitic which is precisely why he used the Nazi analogy to express his frustration with the pandemic response. 

The Third Reich is too easy a historical metaphor for these times. We should go further back in history. A more apt analogy is the Roman empire which reached depths of churlishness before reaching its own depths. For instance, Emperor Caligula appointed his horse, Incitatus, as consul. He was struggling to find a qualified Roman. When asked his opinion on policy, Incitatus defecated and kicked his feces on his fellow senators. The joke wasn’t on the horse. Historical parallels are never exact. But we have struggled to find an FDA commissioner. We don’t spray horseshit these days but we do take horse paste very seriously. Ivermectin has become the sepulcher of sanity. 

We’re no longer just irritated with each other, we’re “appalled,” “disgusted,” “saddened.” Words have lost all meaning because no meaning was attached to them in the first place. If our vocabulary has been devalued, the issues over which we fight have become marginal. Galileo’s belief in heliocentricity was literally earth-shattering. Today’s Galileos fight over one or two vaccine doses in teenagers, whether the risk of vaccine-induced myocarditis is 1/1000 or 1/10, 000. Nothing encapsulates our pettiness more completely than our probability wars.

It’s tempting to conclude that we’ve lost all fucking perspective. But lack of perspective isn’t the whole story. The reality is that we’re thoroughly bored – a side effect of affluence. This is why we have revolutions in our heads and fight wars on our devices. We storm the Bastille without moving from our couches. Instead of calling each other Nazis, we could just as well say “whatever,” press the mute button and roll our eyes.

(*) I’m aware of the irony of comparing the KGB to I-phone screenshots in a piece decrying hyperbole

@RogueRad is a Twitter commentariat who aspires to be canceled


Godwin’s Law and the Rise of Hyperbole on MedTwitter 🙄 posted first on http://rehabitation.blogspot.com

THCB Gang Episode 70, Oct 28 1pm PT – 4pm ET

Joining Matthew Holt (@boltyboy) on THCBGang Thursday at 1pm PT are policy consultant/author Rosemarie Day (@Rosemarie_Day1); Queen of all employer benefits related issues Jennifer Benz (@Jenbenz); ; fierce patient activist Casey Quinlan (@MightyCasey); and Suntra Modern Recovery CEO JL Neptune (@JeanLucNeptune).

With bills in Congress and billions in VC floating around health care, there’s plenty of fodder for the future.

You can see the video below live and the audio will be on our podcast channel (Apple/Spotify) from Friday — Matthew Holt


THCB Gang Episode 70, Oct 28 1pm PT – 4pm ET posted first on http://rehabitation.blogspot.com

Wednesday 27 October 2021

WTF Health: Inside the One Drop – Bayer Collaboration: New Cardiovascular Disease Product Is Just the Beginning

By JESSICA DaMASSA, WTF Health

Bayer’s $98M co-development-plus-investment in One Drop from August 2020 has yielded its first new product: a highly-personalized, AI-powered digital program aimed at preventing cardiovascular disease. While the solution itself is impressive in terms of its predictive analytics and integration into One Drop’s chronic condition precision health platform, what’s really remarkable about this milestone is that it demonstrates what’s possible when a pharma co and health tech startup are truly aligned as businesses, from R&D to go-to-market.

Bayer Pharmaceuticals’ CIO and Head of Digital & Commercial Innovation Jeanne Kehren and One Drop’s CEO Jeff Dachis take us inside their collaboration, with a very candid conversation about how their two orgs have not only developed a new product here today but how they’ve established a solid foundation for a working relationship that’s poised to revolutionize chronic care and define a new market around precision health.

We talk strategy: for Bayer-One Drop… for what the “digital disruption” will bring to pharma… and for “putting a lab on everybody’s arm” via One Drop’s sensor that’s under development. This chat reveals how the thinking behind incumbent-disruptor partnerships has truly evolved, and what it will mean for bringing digital technologies into healthcare in a big and meaningful way. For me, hearing Jeanne say, “it all starts with pharma being ‘self-aware’” and that they need to “we stop slicing things into therapeutic areas and consider the individual” AND recognize that “not everything is going to be process-oriented and shaped like we do for drugs” is a sea-change from what we were hearing only a few years ago from pharma execs about partnering with health tech companies. Things are changing! Tune in to hear so much more.


WTF Health: Inside the One Drop – Bayer Collaboration: New Cardiovascular Disease Product Is Just the Beginning posted first on http://rehabitation.blogspot.com

#Healthin2Point 00, Episode 237 | Horowitz and Tiger Global, Medable, Zerigo Health, and more deals

Today on Health in 2 Point 00, Jess and I talk about Andreessen Horowtiz’s new ventures and the reemergence of Tiger Global in Health Tech. Some big deals for Episode 237: Medable receives 304 million in Series D bringing their total up to $521 million; Zerigo health gets $43 million, bringing their total up to $67 million; Click Therapeutics receives 52 million, but with side deals their total rises to $100 million; Workit Health gets $112 million, bringing their total to $138 million. Among Horowtiz’s new ventures, Patina gets 57 million despite not having launched yet, and Marley Medical gets $9 million. – Matthew Holt


#Healthin2Point 00, Episode 237 | Horowitz and Tiger Global, Medable, Zerigo Health, and more deals posted first on http://rehabitation.blogspot.com