STS News, Winter 2018 -- Recent surveys have shown that physician professional and personal dissatisfaction and burnout rates are at all-time highs. Increasing financial pressures, as well as the rapidly accelerating rate of technological change in medicine, have taken their toll on physicians of all specialties, including ours. In this edition of STS News, Dr. Paul Levy, a member of the Workforce on Practice Management, discusses the topic of physician burnout.
--Frank L. Fazzalari, MD, MBA, Chair, Workforce on Practice Management
Paul S. Levy, MD, MBA, Chief of Surgical Services and Physician Operational Lead, Physician/Administrator Dyad
NEA Baptist Memorial Hospital, Jonesboro, Ark.
I’ve read that US health care is facing a “new” workplace epidemic—physician burnout. This phenomenon is most certainly real and may best be characterized organizationally by a lack of physician engagement. According to a Medscape Physician Lifestyle Survey conducted in 2017, burnout now affects 51% of physicians—up from 40% in 2013.
Burnout stifles innovation and can wreak havoc on your medical staff. What causes burnout? Could it be change fatigue or career choice toxicity? Are some personality types more susceptible, or is the practice environment at fault? Finding answers to these questions has become a priority. America’s health care system clearly is at its precipice, and managing meaningful change is near impossible with a disenfranchised/dysfunctional workforce.
Recognizing burnout is difficult because it manifests in myriad ways. It has been described as “an erosion of the soul caused by the deterioration of one’s values, dignity, spirit, and will.” It can reveal itself via exhaustion, depersonalization, and/or self-doubt. I bet that most of us have experienced at least one of these negative drivers during our training.
The trajectory of health care’s change has evoked workplace emotional barriers—confusion, anxiety, resistance, and frustration. This transformation has pushed many physicians into a lonely place. Some colleagues have left medicine, while others just sadly soldier on. How can physician engagement be fostered in such an environment? It can’t.
Finding a Solution
What would happen if physicians were placed at the center of health care’s change? When health care organizations included physicians early on in value-based care design, buy-in and implementation were improved. In addition, adding physicians to the organizational leadership mix has been another strategic countermeasure. Physician leadership was demonstrated to significantly reduce physician burnout by improving well-being and satisfaction. It boils down to fostering a culture of engagement—effective interpersonal communication, professional camaraderie, decision-making inclusivity, and operational efficiency.
Physician leadership was demonstrated to significantly reduce physician burnout by improving well-being and satisfaction.
At our institution, we have managed change through experimentation with physician/administrator leadership dyads. These dyads promote new avenues for understanding the voice of the physician. Physician and administrative leadership teams efficiently address point-of-care concerns by ensuring open and timely communication. Physician leaders help to rapidly “decode” the issues that trigger a physician’s angst; this leaves more time to do what they do best—patient care.
So far, we have had great success with this dyad model, which puts relationships first. We now have tangible evidence that our culture is shifting. Regardless of the physician burnout cause, we have found that physician leadership can be effective in treating it. The evolution of health care rests on us—lead, follow, or be forgotten.
The author would like to recognize NEA Baptist CEO Brad Parsons, MBA and Administrator Dyad Partner Scott Pippin, MA for their leadership and insight.
To view previous practice management columns, visit sts.org/practicemanagement.