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Physician experiences with utilization management significantly impact patient care and contribute to burnout. Streamlining prior authorization and improving peer reviews are favored solutions.

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Area of Science:

  • Medical Economics
  • Physician Well-being
  • Healthcare Policy

Background:

  • Physician burnout is a growing concern in healthcare.
  • Utilization management (UM) is increasingly implemented by health insurers.
  • The impact of UM on physician well-being and patient care requires further investigation.

Purpose of the Study:

  • To assess physician experiences with UM procedures.
  • To investigate the link between UM and physician burnout.
  • To identify potential policy solutions favored by physicians.

Main Methods:

  • An electronic survey was distributed to 7222 physicians in outpatient settings.
  • Survey responses from 501 physicians were analyzed.
  • Data collected included demographics, UM experiences, burnout levels, and policy preferences.

Main Results:

  • UM procedures like prior authorization, step therapy, and nonmedical switching were reported as major barriers by a majority of physicians.
  • Over half of physicians spent 6-21+ hours weekly on UM-related paperwork.
  • 64% of physicians indicated UM contributed to their burnout, with 8% citing it as the primary cause.

Conclusions:

  • UM significantly hinders clinical and patient care.
  • UM is a substantial contributing factor to physician burnout.
  • Physicians advocate for streamlined UM processes and expert-led reviews.