One Pediatrician’s Journey From Burnout to Purposeful Practice

This article was originally published by the American Medical Association and republished with minor edits.

People are driven to choose a career in medicine not only because of their passion for the art and science of healing, but their deep capacity for care. However, the bureaucracy, systematic redundancies, and chronic inefficiencies that are commonplace in some practices can interfere with that calling, leading to frustration and burnout, as it did for Nalini Casey, MD, a pediatrician at Privia Health.

Dr. Casey’s philosophy as a physician is grounded in compassionate, evidence-based care and empowering parents to be equally active in their child’s health.

“A lot of times that’s through education and teaching them about their child’s illness,” she said. “Anytime they come to me, they’re going to be heard, and I’m going to listen to them.”

To her dismay, that approach was increasingly difficult to maintain in her former practice. Instead, she spent hours correcting documentation errors, redoing billing and coding, and charting late into the night.

“I spent way more time charting than I ever got to spend with my patients and their families,” Dr. Casey said during an episode of Privia’s “The Break Room” podcast where she discussed her move to a new practice to rediscover joy in medicine.

After years of wrestling with administrative overload, clinical bottlenecks, and practice-level obstacles, she was questioning her future in medicine.

“I was starting to feel a little hopeless,” she said. “Was there a practice somewhere I could put my tablet down, look my patients in the eye, and spend the time I needed to with them and their parents?”

A Search for a Better Way

An online search led her to Privia Health. A few days later, while Dr. Casey was out of town and in a hotel room, a long phone call one evening with Lisa Freda, Vice President of Provider Recruitment for Privia Health, changed everything.

“Lisa spent over an hour with me, just getting to know me. Where I trained, where I worked, what my experiences were. She honed right in on what my expectations were, what I wanted, what I came from, and what the other practices were looking for,” Dr. Casey remembered. In fact, she said, “It was like a matchmaking service.”

That conversation led to interviews with several practices, including Bayside Pediatrics, a physician-owned practice in Annapolis, Maryland. Today, thanks to Privia Health, Dr. Casey is thriving there and practicing medicine as determined by her values and standards, and an actively hands-on approach is no longer out of reach.

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Bayside’s internal processes seamlessly blend every touchpoint of care. From the moment a parent calls in the morning to schedule an appointment for a sick child to scheduling a follow-up at the end of that visit, information flows effortlessly between the front desk, clinical staff, and physicians, with no loose ends or overlooked details.

Even lab results are delivered directly to Dr. Casey’s inbox, so nothing slips through the cracks and every patient receives the attention they deserve.

A Culture Designed for Care

Previously, Dr. Casey spent hours combing through records to fix coding issues, which ate into time that she otherwise would have spent caring for patients. Now, her time for delivering hands-on care has been expanded considerably, primarily through Privia Health’s streamlined systems for charting and coding, with built-in safeguards that include an appropriate ICD-10 code before a chart can be closed. Coming with a curated list of options, those tools have been a boon.

“It’s great because at the end of the month, I don’t have 20 charts coming back saying, ‘This ICD-10 code didn’t work for these labs,’” she explained.

The technology has also been critical in helping Dr. Casey tap into a new, larger community of health professionals and resources.

“When I pull up referrals, the system suggests frequently used Privia providers,” she said. “When I first arrived, I didn’t know who to refer patients to, so that was huge.”

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She’s also enthusiastic about specialty-specific templates and macros because “everything about the system is pre-populated with the things that insurance companies require and prompts about the high points they want you to cover, so you don’t have to think of it yourself.”

Dr. Casey also appreciates that many of the system features she uses were designed based on feedback from her fellow specialists.

“I can tell when something’s been created by another pediatrician,” she said. “The templates and order sets just make sense.”

Time for Work-Life Balance

With her administrative tasks now handled promptly, correctly, and efficiently, Dr. Casey has the time she so desired to connect with her young patients and their families.

“I’ve always tried to go the extra mile, and I have time to do that now,” she marveled, relishing her access to a broader care network, including therapists, psychiatrists, emergency physicians and radiologists.

Even the stress of transitioning to a new state and a new patient population was made smoother by the support systems that she now has access to.

“By making everything else — like the charting and coding — so easy, Privia has allowed me to get up to speed on the community here, the type of patient I’m seeing, and how I can best help them, very quickly,” Dr. Casey said.

The impact on her life outside of the clinic has been just as profound too.

“Being able to document, then go home and spend time with my family has been huge,” she said, noting that she had not had that option in years.

Bayside Pediatrics “is well-regulated, professional, and there’s no chaos or drama. Everyone seems happy, and it’s very team-based,” Dr. Casey said. “Privia just gave me this sense of safety that comes from knowing that things are done right the first time. Every day, I feel like I’ve won the lottery by working there.”