Taking Care of Physicians Before They Burn Out
Doctors often are characterized as natural-born achievers with tough mentalities. Through medical school, residency, and years of clinical practice, these innate tendencies are consistently reinforced: Be strong, be thorough, work long hours, never show weakness.
For some physicians, this formula still works. For others, it does not, especially in a health-care market that is more complex and competitive. Doctors are being asked to change and do more in support of their clinical practices and their organizations. The record-keeping and administrative burden has increased, while the patient workload is the same or greater.
The result: Many physicians face severe burnout without the coping skills or support network needed. A Mayo Clinic estimate suggests that physicians show double the rate of emotional exhaustion as other professionals. Front-line clinicians such as family practitioners, ER specialists, and psychiatrists are at particular risk. Researchers at Stanford Medicine found that physician burnout costs their system nearly $8 million per year in lost productivity, turnover recruitment, and replacement costs. Interestingly, one study suggests that most executives and clinical leaders perceive the problem to be worse at other organizations than within their own.
Burnout can extend to a growing group of MDs categorized as “physician leaders” or “physician executives”—department heads or service line leaders all the way up to C-suite roles such as chief medical officer or chief physician executive. Most physician leaders are expected to balance a ratio of clinical to administrative work—50/50, for example—but the reality is that both demands vie for full-time attention.
Steps to Prevent Overload
There is no quick fix or magic pill, if you will, for physician burnout. A few simple steps include establishing mentoring programs for new physicians, and designing compensation packages that prevent over-scheduling and pay for activities outside the typical scope of practice. Many hospitals and clinics are creating “Just Culture” environments that emphasize shared accountability for patient safety and reducing errors.
Other steps health-care organizations can take to address burnout from clinical and administrative overload include:
- Look to physician organizations and industry associations. National organizations representing health practitioners are addressing the burnout issue. The American Psychiatric Association, for example, has developed a wellness portal that includes a self-assessment tool for its members. The AMA’s STEPS Forward program aims to put physician satisfaction and joy on a par with patient care and satisfaction. Help yourself before you can help others, the thinking goes.
- Implement relevant training. Offer physician wellness or resiliency training (and reimburse as continuing medical education, or CME). Incorporate emotional intelligence (EI) and coping skills training into professional development and leadership development programs. Major health-care providers and medical schools, from the Mayo Clinic to UC Berkeley, have created their own physician leadership programs, which include soft skills components. Many programs are available for physicians whose organizations may not have the resources to establish their own training.
- Consider soft skills in hiring and promoting physicians and physician leaders. While a doctor’s resume and credentials are ultimately what qualify him or her for given roles, soft skills —emotional intelligence, collaborative ability, listening, etc.—are what can make the difference in their ability to take on additional responsibility, stay balanced, and lead others. In hiring and promoting, consider the “in person” over the “on paper” physician.
- Rely on psychometric assessments. Related to the above point, modern assessment methodologies can be used to gauge physician soft skills and behavioral tendencies, to pinpoint strengths, as well as areas of need. Assessments are helpful in getting physicians to know themselves as their peers and staff see them, and for their organizations to know how to support them.
- Hire a wellness-focused executive. Chief wellness officers are becoming more commonplace in large organizations that prioritize keeping workers healthy and productive. Health care is getting on board, perhaps with a CWO role or, for physicians, a position such as “Medical Director, Physician Wellness & Satisfaction.” Often the CMO or another physician leader will take on more responsibility for clinician well-being.
- For physician leaders, consider dyad partnerships. Physician/non-physician dyad (or triad) partnerships are increasingly common as a means of playing to the relative strengths of different executives. In a symbiotic dyad partnership with a career administrator, a physician leader can prioritize leadership in quality of care, clinical outcomes, and managing clinical assets, while the co-administrator can focus more on non-medical business operations.
What drives physicians often can derail them. Hospitals, health systems, and related employers need to diagnose the issue and prescribe solutions.
Carl Fitch is a consultant in Witt/Kieffer’s Emerging Physician Leaders practice, identifying medical directors and other physician leaders on behalf of hospitals, health systems, and other health-related organizations. He has nearly 30 years of experience in health-care talent acquisition, business development, and operations.