Utilization management and physician burnout

Am J Manag Care. 2024 Nov;30(11):561-566. doi: 10.37765/ajmc.2024.89626.

Abstract

Objective: This study was designed to assess physician experiences with utilization management and burnout and investigate whether they are linked.

Study design: We conducted an electronic survey with items related to demographics, profession, utilization management, burnout, and potential policy solutions.

Methods: The survey was sent to 7222 physicians working in outpatient settings who were recruited from a large, opt-in database. Outcome measures were responses to categorical and Likert-style survey items related to demographics, utilization management, burnout, and potential policy solutions.

Results: Of 7222 requests sent, 501 physicians completed the survey and were included in the final data set (77% men; mean [SD] age, 57 [9.8] years; mean [SD] years in practice, 24 [8.9]). Of these, 200 were general practitioners and 301 were nonhospital specialists. Physicians indicated that utilization management procedures for prior authorization (81%), step therapy (79%), and nonmedical switching (69%) were major or significant barriers to their clinical and patient care. More than half (52%) reported spending 6 to 21 or more hours per week on paperwork related to health insurance utilization management, 67% had experienced burnout at some point in their careers, and 64% indicated that utilization management had been a contributing factor to feelings of burnout, with an additional 8% citing it as the main factor. Physicians favored streamlining prior authorization practice (77%), requiring step therapy to be based on science (73%), and ensuring that peer-to-peer reviews are done by qualified medical experts (67%).

Conclusion: These findings indicate that utilization management has a detrimental impact on physicians and patient care and contributes to physician burnout.

MeSH terms

  • Adult
  • Burnout, Professional* / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physicians* / psychology
  • Physicians* / statistics & numerical data
  • Surveys and Questionnaires
  • United States