Physician Burnout and Utilization Management: Investigating the Impact of Administrative Burdens

A survey of 501 outpatient physicians found that utilization management procedures, particularly prior authorization (81%), step therapy (79%), and nonmedical switching (69%), are perceived as major or significant barriers to clinical care and may lead to physician burnout.

The increasing administrative burden on physicians due to utilization management policies has been linked to both reduced patient care efficiency and physician distress. Prior authorization, step therapy, and nonmedical switching are intended to control health care costs but may delay necessary treatments and increase the workload on providers. This study aimed to assess the relationship between utilization management policies and physician burnout while also identifying potential policy solutions favored by physicians.

An electronic survey was distributed to 7222 outpatient physicians recruited from a large opt-in database. The survey included questions on demographics, professional background, utilization management experiences, burnout, and policy preferences. Categorical and Likert-style responses were collected and analyzed.

Of the 501 respondents, 77% were men with a mean age of 57 years (mean years in practice = 24), 200 were general practitioners, and 301 were nonhospital specialists.

The survey revealed that most physicians viewed utilization management policies as a hindrance to effective clinical practice, with prior authorization, step therapy, and nonmedical switching being the most burdensome. More than half of respondents (52%) reported spending between 6 and 21 or more hours per week on paperwork related to utilization management. Physician burnout was prevalent, with 67% of respondents reporting having experienced burnout at some point in their careers; 64% attributed utilization management as a contributing factor, and 8% cited it as the primary cause.

Physicians strongly supported policy changes, including streamlining prior authorization (77%), ensuring step therapy is science-based (73%), and requiring that peer-to-peer reviews be conducted by qualified medical professionals (67%).

Limitations of the study include a low response rate (6.9%), the use of an opt-in database, which may not fully represent all outpatient physicians, and the reliance on self-reported experiences, which could introduce recall bias.

“These findings indicate that utilization management has a detrimental impact on physicians and patient care and contributes to physician burnout,” the authors concluded.

Reference
Struthers A, Chapman MA, Charles PD, Conschafter A, Cooper J, Clingham G. Utilization management and physician burnout. Am J Manag Care. 2024;30(11):561-566. doi:10.37765/ajmc.2024.89626