A recent webinar on clinician burnout and physician wellness offers helpful pointers but is missing essential elements.
For those who are new to the subject of clinician burnout and how to begin addressing it, a decent overview can be found in a recent free 1-hour HealthLeaders Media webinar "The Winning Edge - Promoting Physician Wellness" and/or perusing a January 22 written summary of it by Chris Cheney, a HLM editor.
In the webinar, Mr. Cheney moderates a panel discussion with Thomas Campbell, MD, MPH, chief wellness officer at Allegheny Health Network; Jim Gilligan, vice president of health system and group partnerships at the American Medical Association; and Amy Jibilian, MD, chief wellness officer at Lehigh Valley Health Network. Among the several helpful observations, I want to commend the AMA's Jim Gilligan's entreaty that healthcare organizations assess clinician burnout using one of the several nationally recognized, validated surveys. [Note: not the same thing as -- and one ought not rely on -- physician satisfaction survey data.] He specifically encourages hospitals to track and report on 5 key metrics of physician well-being: reported sense of satisfaction, reported sense of stress, reported sense of burnout, reported sense of feeling valued, and intention to leave. As the adage goes, "if you don't measure it, you can't move it". Â
The panel also nicely highlighted the value of providing mental health support to physicians; creating a psychologically safe environment for clinicians to ask for help; and applauded the good work of the Dr. Lorna Breen Foundation in getting hospitals to eliminate licensing and credentialing questions about one's mental health history. Bravo!
However, I found a glaring omission in the webinar about the role and responsibility of executives regarding clinician burnout. While the panel appropriately referenced the tripartite Stanford Professional Fulfillment model -- practice efficiency, culture of wellbeing, and personal resilience -- it failed to explicitly link management and management practices' impact on the culture of wellbeing.  The pronounced and growing schism between the C-Suite and front-line clinicians was never referenced.  Similarly, while the EHR was specifically cited as a major cause of practice inefficiency, the panel did not mention the many other factors in the clinical workplace, ultimately controlled or at least substantially influenced by management, that bear upon practice efficiency.  Indeed, at no point did the panel note that burnout is an occupationally induced condition — an individual response to chronic problems in the workplace.  It is NOT due to a lack of resilience on the part of clinicians.
If one is looking for a general overview about clinician burnout and some general ideas about ways to combat it, this webinar is a reasonable starting point. But for anyone looking for a road map on how to carry out a well-organized, comprehensive effort to reduce clinician burnout, this HLM webinar is not it.
Solutions for Hospitals, Health Systems, and Medical Group Practices:Â Leadership-Driven Changes
The locus for curing clinician burnout and staffing challenges 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 mistrust or even 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.