I recently received an online article in my inbox that caught my eye. So often I just click delete as my schedule often does not allow for perusing articles that are “outside” my practice arena. The title of The Atlantic article from May 11 was “The Burnout Crisis in American Medicine.”
The discussion related to medical doctors, but I felt much of it could also relate to the diabetes educator. The article centered on the difficulty in utilizing the very tools, like Electronic Medical Records (EMR), that were supposed to make taking care of patients not only more streamlined, but also more effective. However in this case, when the physician tried to find the right box to click, they spent more time away from the patient than with the patient. A parallel example the article gave was of a person trained to be a chef, who was told to keep track of all the ingredients used in every plate made. When the chef went to look up eggs, they found that there were way too many options: egg whites, eggs in the shell, eggs out of the shell, egg yolks. You get the idea.
EMR and electronic downloads are often cumbersome and lack the personal exchange so important to overall care for the client.
Although technology can be an advantage, it can also be a burden. It can take us away from our clients and create a layer of duplicity when we are also required to keep paper charts, as the EMR we use does not allow the documentation needed for diabetes education, and therefore compliance for our diabetes education program. In so doing, we are not utilizing the very skills for which we were trained: taking care of people with diabetes, not to prove our outcomes, but to help them with theirs.
In addition, as I work with technology every day in my practice, I see other concerns arise. Sensor data is shared, which is great, but communication is often not by phone and instead through other, less personal means, such as email and MyChart. This may be very efficient, but important questions are not addressed prior to suggesting medication adjustments, such as "When this sensor value demonstrates a rise in blood glucose, do you happen to know why that occurs? Is it a skipped dose? Coffee consumption? Sprint training for an upcoming athletic event?" Because clients want the educator to just “look at the data and make suggestions” during a face to face visit, the quantity of these requests can become overwhelming and create an environment that nurtures burnout.
EMR and electronic downloads are often cumbersome and lack the personal exchange so important to overall care for the client. This lack of human connection is not what we were trained to do. We need to find a way to continue the most important piece of our practice – sitting down one-on-one with the client, assessing their needs and making a plan for them so we and they do not get burned out on medicine.
About the Author:
Carla Cox is a registered dietitian and certified diabetes educator. She has been a certified diabetes educator for over 25 years, and served as an assistant adjunct professor for 14 years, teaching in areas of sports nutrition and exercise physiology. Currently she works in Missoula, Montana as a diabetes educator in both in- and outpatient settings.
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