Please tell me it's a reporting or editorial error, not what was actually said!
I routinely follow about a dozen or so health-related publications, one of which is the online newsletter and publisher, Health Leaders (101 Creekside Crossing, Suite 1700-735, Brentwood, Tennessee, 37027). It usually does a credible job of providing industry news briefs, summarizing /highlighting articles on topical issues that have appeared elsewhere, and occasionally presenting its own original material. It was in this latter context that I took note of a message from Health Leaders on December 9 inviting recipients of its newsletter that it had generated a report -- sponsored by Microsoft -- from a gathering of some two dozen Chief Medical Officers: "HealthLeaders CMO Exchange". This sounded interesting so I downloaded the report.
The brief 2-page report highlighted "3 key takeaways" from the CMO Exchange: 1) the physician burnout challenge; 2) the role of the CMO as an intermediary between the medical staff and executive team; and 3) the growing need for advanced practice providers (APP's). Those all seemed to be perfectly appropriate and consistent with findings from other sources.
Here's the problem. In the discussion about physician burnout, the report writer Christopher Cheney, liberally quoted one of the CMO's who made the following statement: “I think there are ideas on how to address physician burnout, but no good clarity on what would be most effective at this point (emphasis added)”. And this: "We need to have burnout programs (emphasis added) that are for everyone, not just physicians because we affect each other." Both statements if taken verbatim, are wrong. Very wrong.
There is good data on what works (see Paul DeChant, MD, MBA, Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine; Christina Maslach, PhD, and Michael P. Leiter, PhD, The Burnout Challenge, Harvard University Press, November 2022; the American Medical Association's "Steps Forward" and "Joy in Medicine" services).
Here's what doesn't work: wellness/personal resilience programs (e.g., employer-sponsored yoga classes, gym memberships, meditation sessions, time management courses, recharge rooms, etc.) While these do have value as enrichment activities or as nice additions to an employer's benefits plan, they do not meaningfully impact burnout. The reason? As the World Health Organization (WHO) makes clear, burnout is an occupationally induced phenomenon, a personal reaction to chronic, systemic issues in the workplace. Burnout does not arise from a lack of personal resilience. Indeed, conflating the two shows a profound lack of understanding of the causes of -- and solutions for -- burnout. Substituting wellness/personal resilience programs in lieu of making perdurable changes to workplace processes and leadership practices also just contributes to clinician cynicism vis-a-vis the executive suite.
Either the writer (or his editor) did not correctly quote this CMO or the CMO is not up to speed on the causes of and countermeasures to clinician burnout.
Solutions for Hospitals, Health Systems, and Medical Group Practices: Leadership-Driven Changes
The locus for curing clinician burnout and staffing shortages runs through the C-suite. Here are examples of leadership-driven changes to the workplace that my colleague Paul DeChant, MD, MBA and I often recommend:
> Regard clinicians as knowledge workers who are given significant latitude to make clinical decisions without unnecessary administrative encumbrances or delays
> Consistently apply one or more of the improvement sciences (Lean, Six Sigma, operations research, agile, design thinking) in consultation with front-line staff to improve workflow and reduce delays, waste, inefficiency, and job skill mismatches
> Expect all leaders, but especially senior executives, to do periodic job shadowing of front-line staff (where observing and deep listening are emphasized) in lieu of "rounding" (a largely ineffectual, if widely practiced activity)
> Create and require leader standard work (LSW).
> Develop and deploy a sophisticated, deeply ingrained, and rigorous daily management system (DMS) supported by visual display boards or monitors
> Judiciously invest in AI/ML solutions -- selected, tested, and endorsed by front-line staff -- that eliminate or at least markedly reduce data entry, administrative requirements, and/or repetitive tasks that are non-value add
> Support near-continuous optimization and remediation of the EHR (there's no such thing as "it's all set")
> Get rid of superfluous or outdated policies, procedures, redundant approvals, and other stupid stuff (GROSS)
Ready to transform your hospital or workplace?
Are you frustrated by adversarial relationships between front-line clinicians and senior leadership? Organizational Wellbeing Solutions was formed to enable senior leaders to identify the specific drivers of clinician burnout in their organization; and to support leaders in designing and executing a comprehensive plan to stop clinician burnout, increase retention, and improve operating results. A hallmark of our consultancy is correcting the all-too-frequent distrust and alienation Clinicians feel toward the C-Suite generally and the CEO in particular. Let us help you help your organization and its clinicians develop a more trusting, aligned, and productive working relationship.
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