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5 Steps to Position Physicians for Success and Prevent Burnout

January 3, 2018

I recently had the pleasure of serving as a panelist for a class in Georgetown University’s Executive Master’s Program in Health Systems Administration.  One of the panel questions generated a lot of discussion was:

“What have you done to address burnout of clinicians?”

Physician burnout is a hot topic these days.  A recent study of US physicians found that nearly half had at least one symptom of burnout.  This is particularly disconcerting because we are facing a provider shortage and are asking more than ever before of providers.

What is burnout?  The formal psychiatric definition is an “exceptionally mediated job-related dysphoric and dysfunctional state in an individual without major psychopathology.”  What does THAT mean?  Basically, it’s a physical or mental collapse caused by overwork or stress.  It’s where operational demands of a role exceed an individual’s capacity.

Much has been written recently about managing/treating/resolving burnout.  For instance, Shanafelt and Noseworthy outline the nine strategies to resolve burnout in Mayo Clinic Proceedings.  Below are the strategies, along with some thoughts based on my observations (generally, it looks like a solid plan): 

  • Recognize and evaluate the problem

  • Identify factors that contribute to burnout and invest in solutions
    (Of course, a good starting point.)

  • Provide at-risk individuals with self-care resources
    (Also, rather obvious, but not every organization does this.)

  • Identify the behaviors of leaders who can positively or negatively impact burnout
    (I like this one.  Just because physicians traditionally don’t trust administration, it doesn’t mean that administrators aren’t actually doing things that worsen the relationship and contribute to provider frustration.)

  • Foster a community atmosphere
    (No doubt that culture impacts the individual’s frustration and capacity.  A sense of community and collaboration allows people to handle frustration better.  When there is a sense of an adversarial relationship, frustrations are magnified.) 

  • Strategically offer rewards and incentives
    (If it’s a program designed to make providers feel appreciated, it can be valuable.  If it’s not partnered with honest work to decrease frustrations and operational demands, it may not be well-received.)

  • Assess whether the organization’s stated values and mission are being followed
    (Wherever possible, tie everything to the mission and make providers feel how important they are to the mission.)

  • Promote flexibility and work-life balance through organizational practices and policies
    (Yes.  Providers need to know that the organization cares about their well-being.)

  • Create targeted interventions to enhance efficiency while decreasing clerical work through a systems approach
    (This is the recommendation that matters.  What is causing the increased demand and decreased capacity and what can you do about it?)

Most health systems have a new, valuable, and quite unique workforce – one they need to successfully manage and develop.  Physicians are NOT fungible commodities.  For too long, some hospital administrators saw them this way.  Too often, I have been asked by an administration to create a physician “engagement” plan when, in reality, what they wanted was a physician “control” plan.  Leadership merely wanted to find a way to get physicians to do what they needed – to cooperate, rather than collaborate.

I’ve always believed that a substantial percentage of burnout is really just physician frustration, from resolvable issues reaching a critical point.  There is a growing provider shortage and administrators are looking for some magic solution for overworked and frustrated providers.  The reality is there is no simple solution – although there is an obvious one:  Position physicians for success and prevent burnout in the first place.  A good starting point:

  1. Partner with physicians to accomplish the system’s goals and to fulfill the mission. Make them feel that they are valued partners.

  2. Engage physicians in re-designing care delivery models. In other industries, this would be the first place to start – how do we deliver our product in the most effective way possible with the resources available?

  3. This means, wherever possible, removing operational barriers and providing the resources physicians need to be successful and productive. How many physicians have complained about the inefficient OR for a decade or more?  Physicians have enough pressures – remove small frustrations today.

  4. EVERY physician should have a physician mentor, a service line administrator working on his or her behalf, clear performance and career goals, and a plan to get there. This takes some work – but someone needs to understand the goals of every physician.

  5. The plan should include tools and resources to improve individual resilience – but these are meaningless if the system is not doing all it can to reduce demand and to increase capacity. Don’t discount the value of “honest effort” – even if you can’t make the physician’s world perfect, he or she will be far less frustrated if they feel like they are heard, see a plan, and an honest effort.

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Bryan Warren Bryan Warren is the President of J3 Personica, a consulting, assessment, training, and coaching firm, and a guest blogger for PSI. Bryan is an expert in progressive talent strategies, with a particular focus on leader and physician selection and development.