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Norlanco Family Medicine is fighting burnout as a team.

Scott Conley, M.D.

John Yoder, M.D.

The 19 providers at Lancaster General Health Physicians’ largest family practice manage panels of up to 3,300 patients. Like most of their family medicine peers, Norlanco physicians typically spend half of their time on tasks that don’t require their medical knowledge, often working in off-hours from home.
In search of possible solutions to his own feelings of burnout, Dr. Scott Conley googled “finding joy in practice.” Many of the suggestions were tenets of team-based care, an approach linked to greater physician job satisfaction, more personalized care and stronger patient-physician relationships.
“Physician burnout was the main driver in our decision to start pursuing team-based care at Norlanco,” Dr. Conley said.
After a short pilot, Norlanco officially launched team-based care last August. The 87 staff members are divided into three teams, with each practicing at the top of his or her license, with clearly defined duties. The goal is to share tasks, maximize resources and free up physicians to treat patients.
While team-based care isn’t a cure-all, it has led to positive changes at Norlanco. In a recent informal survey, the practice’s physicians showed improvement in all indicators for burnout, including greater job satisfaction and fewer reports of feeling emotionally drained, Dr. Conley said.
Managing Physician Dr. John Yoder said practicing medicine has become increasingly demanding and complex, which includes managing huge volumes of patient data. Those tasks, while important, can limit physician efficiency: Before Epic, Dr. Yoder could see 20 patients in a half-day. Now 12 feels like a lot.
“There aren’t too many spare minutes in a physician’s day,” he said. “We see patients every 15 minutes. If the team can handle more population-health tasks and increase in-basket management support, my day is going to be a lot better.”
Allowing all team members to practice at the top of their license helps reduce those extra tasks that don’t require medical knowledge, Dr. Yoder said. He and other Norlanco physicians now take home less work. The practice has improved its overall efficiency, and staff members are more engaged.
“My day ends, and I tend to have most of the work done around me,” Dr. Yoder said. “There are no medication refills, and the messages in my in-box have been managed. That’s a good thing.”
Despite the positive changes, staffing and other resource limitations have kept team-based care from reaching its full potential at Norlanco, Dr. Conley said. The office’s current layout prevents co-location of team members, a key tenet to team-based care. He hopes renovations will be coming.
The Norlanco team handles the practice’s day-to-day business needs pretty well, Dr. Yoder said, but finding the right provider-to-staff ratio is necessary for staff to take on the population health outreach work originally envisioned to influence quality metrics intended in the team-based care delivery model.   
“Ideally, we need to let doctors see patients and have others on the team take care of those tasks that don’t require their level of medical knowledge,” he said. “We’re still not there yet.”

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