Dr. Alicia Jacobs: AI-generated clinical notes can help reduce burnout in primary care

This commentary is from Dr. Alicia Jacobs, wellness informatician at the UVM Health Network. and ACO medical leader at OneCare Vermont.

Tourists still love to visit picturesque Vermont, but many new and old residents are considering leaving because they can’t find a primary care provider. Primary care is a valuable and stressed workforce.

As a family physician and primary care leader for over 20 years, I have seen and experienced the rising tide of burnout and professional dissatisfaction among primary care providers. Interventions to improve their workload have been few. Then I discovered ambient AI for clinical note generation – it has brought joy back to my practice.

Primary care physicians save lives and are essential to keeping communities healthy: communities with more primary care physicians have better outcomes and people in those communities live longer. Primary care physicians minimize the need for specialty care and are the backup when specialists are not available. They serve all who come and entire communities. Through longitudinal trusting relationships, we are curative and therapeutic.

Primary care is in crisis as widespread burnout has led to a decline in the workforce. More than half of of primary care physicians suffer from burnout. Burnout increases staff turnover, early retirement, or reduced time spent providing patient care, leading to a contraction in the overall size of the primary care workforce.

Since 2020, administrative tasks have skyrocketed for primary care physicians, sometimes taking up more than 50% of their time. “Paperwork” is a complex set of frustrating, time-consuming tasks that cause cognitive overload. Long hours spent working with electronic medical records, pressure to obtain quality metrics, and meaningless administrative burdens such as prior authorizations prevent us from connecting with patients.

The antidote to burnout is to increase the percentage of daily time a person spends on meaningful work. At the University of Vermont Health Network, we tested ambient AI products that record a natural conversation between patient and physician to automatically generate the clinical note.

This approach, focused on helping reduce the administrative workload of creating notes, showed that burnout rates among primary care physicians dropped by 33% in eight weeks. No other intervention to reduce burnout has worked as well. Now our primary care physicians can better focus on caring for many residents of Vermont and upstate New York. These patients directly benefit from this improvement in their providers’ well-being.

In terms of feedback, our doctors say that ambient AI reduces their cognitive and administrative workload, while improving their presence in the room with the patient. AI has also increased their professional satisfaction (an indicator of joy at work).

A secondary study conducted by the University of Vermont’s Larner College of Medicine has shown that the notes are just as high quality as those generated by the doctor. Our patients are noticing this too: they’ve given feedback that they appreciate better eye contact, less screen time, and a calmer experience.

AI is not a panacea for our healthcare problems; every new technology has its downsides. Doctors still need to interact with the computer to enter diagnoses, orders, refill medications, and input instructions for patients. Learning new systems takes time and energy. The abstraction of large language models, machine learning, and the occasional hallucinations of generative AI can be difficult to understand. Any technology that standardizes the pace and content of our notes has the potential to diminish doctors’ voices and personalities.

We will also need to consider the impact this will have on the next generation of physicians. However, none of those challenges or shortcomings outweigh the potential for positive, transformative change in the way we, as healthcare workers, engage with technology. Physicians have asked for technology to help us do what is important to us, and now it exists.

It is possible to use AI in healthcare safely. For me, applying AI has been magical. We can help save the primary care workforce by removing one of the obstacles to a joyful and sustainable practice and using ambient AI.

Let’s take advantage of a way to share contracts with AI providers and find benefactors to support primary care. Then, we should continue to look for innovative ways to help stabilize this valuable primary care foundation for our healthcare system.