Regulatory requirements continue to burden U.S. physicians, with downstream effects on the patient

Back in 2022, the U.S. Surgeon General issued a national advisory on health worker burnout, with administrative burdens called out specifically in the list of key causes.¹ Unfortunately, not much has changed since then, with worries that regulatory issues in healthcare have indeed worsened. Research from the Physician Sentiment Survey (PSS) shows that on a weekly or more basis, nearly two-thirds (64%) of physicians feel overwhelmed by administrative requirements and burdens.²

Local and federal government regulations have been implemented into U.S. healthcare systems to help ensure things like safe use of medicines and pharmaceuticals, that clinicians and their assistants are properly trained, and that hospitals and other healthcare facilities meet standards of safety and cleanliness. But many sources and healthcare officials state that a vast number of unnecessary regulatory requirements are making day-to-day work more difficult for physicians in the U.S., and that this regulatory burden is exacerbating the broader crisis of physician burnout.³

Data from the PSS report shows that administrative and bureaucratic burdens are one of the top five challenges physicians are experiencing today. But what exactly does it mean when we say this, and how might this issue affect the patient?

Let’s take a closer look.  

Excessive bureaucracy and administrative burden

Physicians today must deal with varying levels of bureaucracy in their daily practice, and that bureaucracy increases with each payer contract that a practice participates in, both Medicare and commercial. The types of bureaucracy in this context can be broad—from value-based care VBC and Merit-based Incentive Payment System (MIPS) compliance to local reporting requirements for certain prescriptions and vaccines. But the fact is, nearly six-in-ten (59%) physicians feel overwhelmed by too much local and federal government bureaucracy.⁴

Among the most burdensome for clinicians are prior authorization, audits and appeals, and the Medicare Quality Payment Program.⁵ There’s also significant additional reporting required if you accept Medicare and Medicaid patients.

At the state or national level, many policy issues are seen as essential for elected officials to address, but by far the top recommendation from physicians is minimizing current documentation requirements. Based on this data, we can see a renewed focus on reduced bureaucratic burden in the future as the federal government seeks to tackle the crisis of physician burnout.  

Complex healthcare regulatory requirements

Compounded with this issue of excessive bureaucracy is the struggle of physicians to keep up with ever-changing regulatory requirements. The overall regulatory burden on medical practices continues to rise, with the PSS revealing that 91% of physicians feel the burden of regulatory requirements is worsening, and close to half (47%) cite regulatory requirements as a contributing factor to their burnout.⁶

Some of this burden can be attributed to administrative and documentation tasks required for federal mandates like MIPS. In one study published by NIH, clinicians and administrators spent more than 200 hours per physician on MIPS-related activities. Compliance can cost physicians almost $13,000 per year,⁷ and these government regulations can require reporting that is outside the scope of real patient care efforts, leading to increased burnout.

Identifying and addressing these issues within our current healthcare system is key. Increased transparency for MIPS and reduced documentation are both listed by the American Medical Association as opportunities to reduce this pain point for physicians. By working to address pain points like excessive regulatory requirements, we can create positive outcomes like freeing up resources to help combat staffing crises, easing the burden of burnout on physicians, and getting patients better access to the care they need. Many insurance companies are updating their policies to no longer require things like prior authorization, but the data shows that there’s still more work to be done on this front if we seek to decrease physician burnout in future.  

The effect of healthcare bureaucracy on the patient

We've seen how the challenge of bureaucracy and regulatory requirements directly affects physicians in their daily workflows and patient encounters, but what about the patients themselves? Are they feeling this pain point as acutely as their care providers?  

Well, research shows that too much administrative work does indeed have downstream negative effects on the patient population. Overall, patients see less time with their caregivers, who are otherwise occupied with administrative tasks, and they also face unnecessary hurdles to receiving care (such as prior authorization) as well as higher healthcare costs.⁸

What’s more, 97% of group practices surveyed said that a reduction in regulatory burden would allow them to reallocate resources to patient care.⁹ Studies show that reducing regulatory requirements that do not improve patient care will help group practices to better focus on providing comprehensive patient care and will allow them to invest in initiatives that improve the delivery of care. If the quality of patient care is to improve in the future, barriers to care such as administrative tasks and prior authorization need to be effectively addressed.

When examining this research on the burden of regulatory requirements on healthcare providers, we asked Greg Carey, Director of Government and Regulatory Affairs at athenahealth, to weigh in: “We are on an unsustainable path of ever-increasing burden on physicians. Policymakers and technology partners share a responsibility to address burnout. It's as important to look in the mirror at today's quality programs and "check boxes" to ensure they create value for the patient, as it is to enable innovative new technology like Artificial Intelligence to tackle healthcare’s thorniest administrative processes. Policymakers must avoid the urge to be overly prescriptive and unintentionally send physicians further down this unsustainable path with a bleak outcome.”

It's clear from both the PSS research and other healthcare officials that there are large-scale industry and policy changes needed to make improvements for the benefit of both physicians and their patients. As the physician burnout crisis continues to put more weight on these issues, physicians and group practices are looking for industry adjustments that will enable them to spend more time focusing on patient care, and less time on reporting and administrative tasks.