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    A concierge physician's advice for battling burnout


    Your good business decisions should foster happiness. While converting my hamster-treadmill traditional practice to concierge, I explained to my patients that a burned-out doctor who retires ASAP is good for neither his patients nor himself. Ten years into concierge medicine, I only wish I had converted five years earlier. I enjoy working hard, seeing half as many patients per day and doing a great job for them while reversing my burnout trajectory. With a slight income gain, working 25% fewer hours per week, I have more time for family and personal activities. Don’t take your time for granted, life is too short to spend it unhappy.

    For physician-employees, consider an alternative to being the $100 per hour clerk—hire a scribe for $12 per hour, the median hourly rate.(4) Full time, with benefits and taxes, that’s about $32,500 per year. Tell your manager you could generate an extra $73,100 per year of revenue by hiring a scribe. Subtracting the scribe expense, that’s still $40,600 per year of pure profit for your company, even in primary care.

    The more earning potential you have, the better you will do with a scribe. The financial math is simple, and so is the burnout math. That’s why smart managers hire scribes. In my medical community, scribes are multiplying.


    TRENDING ON OUR SITE: 9 ways physicians have it worse than everyone else


    The only EHR stress I have is in tracking down and trying find the relevant information in consulting specialist EHR notes. I usually find the answer to my referring question in the last two lines of the six-page note. I am sure there is someone, somewhere, who appreciates all that prose and the work behind those pages.

    Assess your life’s balance:  professional, personal, physical and spiritual. If the professional part is dragging you down, take action. If you don’t wish to, or can’t afford to, quit medicine, and an EHR is unavoidable, hire a scribe. If you are in the tiny minority of us without an EHR, hopefully this blog affirms your decision. Life with an extra three months per year spent with family and hobbies, anyone?


    1.     Arndt, A. (September/October 2017).  Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations. Retrieved from       http://www.annfammed.org/content/15/5/419.full

    2.     Shanafelt, T. (July 2016). Relationship between Clerical Burden and Characteristics of the Electronic Environment with Physician Burnout and Professional Satisfaction.  Retrieved from http://www.mayoclinicproceedings.org/article/S0025-6196(16)30215-4/abstract

    3.     Grisham, S. (April 5, 2017). Medscape Physician Compensation Report 2017. Retrieved from https://www.medscape.com/slideshow/compensation-2017-overview-6008547#31

    4.     Paysccale.com (November, 11, 2017). Medical Scribe Salary. Retrieved from https://www.payscale.com/research/US/Job=Medical_Scribe/Hourly_Rate





    Dr. Kihm practices full-time solo concierge internal medicine in Durham, in Durham, NC. He is a member of the board of directors, American College of Private Physicians, www.ACPP.md.  Active in volunteering, Dr. Kihm sees patients at the homeless shelter medical clinic in Durham, NC, and regularly flies medical missions to the Outer Banks of North Carolina and Appalachians. 

    John T. Kihm, MD, FACP
    Dr. Kihm practices full-time solo concierge internal medicine in Durham, in Durham, NC. He is a member of the board of directors, ...


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