Physician burnout is a problem that can be solved.
Discover two ways to reduce physician burnout for your healthcare organization.
The Problem of Physician Burnout
Rates of physician burnout have been increasing and are at epidemic proportions. Fifty-four percent (54%) of all practicing physicians experience one or more of its symptoms. Those symptoms include:
- emotional exhaustion,
- depersonalization, and
- a reduced sense of personal accomplishment.
For physicians, burnout affects them at the core of their well-being, both at work and at home, and both physically and mentally. According to a survey of over 2000 physicians conducted by Alan H. Rosenstein, MD, burnout results in:
- Insufficient work/life balance
- Conflict at work and at home
- Feelings of irritability, moodiness, anger, and hostility
- General tiredness, lack of sleep, and difficulty sleeping
- Negative impacts on physical and especially mental health, such as depression and anxiety or symptoms such as apathy, cynicism, and less interest in engaging with others or in normal activities
If that’s not enough, the consequences of physician burnout ripple out to healthcare organizations. They are serious and include:
- diminished physician empathy;
- patient safety–related concerns such as difficulty making decisions or communicating effectively with others;
- decreased patient ratings of quality of care;
- decreased job satisfaction and productivity;
- retention and turnover problems; and
- increased medical errors and liability claims.
It’s clear that we are at a crisis point in healthcare.
How can we heal our healthcare system if its foundation – its healthcare providers and administrators – is suffering so badly?
It’s the ultimate irony: a system and people venerated for their ability to care for others have been remiss in caring for their own.
So now, more than ever, a priority must be set on taking care of our physicians, before the entire system implodes.
What could possibly help turn the tide and be achievable without outrageous expenditures of limited time and money?
It requires the commitment of healthcare leadership to prioritize and execute on sustainable resiliency training for their staff – from top to bottom. And that includes resiliency training for healthcare leaders too.
Burned Out Healthcare Leaders May Be Contributing to Escalating Physician Burnout
Studies have shown that healthcare leadership is not only experiencing burnout too, but they may be contributing to this cycle of burnout within the system.
For example, a study by Dr. Roy Poses from Brown University highlights the damage healthcare leaders can have on the psyche of physicians. He surveyed 287 family medicine and internal medicine respondents, assessing their level of burnout against a Perceived Leadership Integrity Index. The physicians were asked whether they felt the leader:
- Supported the physician’s core values
- Prioritized quality over costs
- Positively responded when the physician raised quality issues
- Demonstrated interest in patient care above self-interest
- Was honest
The study found that a low score on this index was significantly correlated with physician burnout and the physicians’ intention to leave.
This study is further supported by a more recent study by expert Tait Shanafelt of over 3,000 physicians in the Mayo Clinic system. It found the composite leadership scores of immediate supervisors, division and department chairs strongly correlated with physician burnout. For every 1 point increase in composite leadership scores, there was a 3.3% decrease in likelihood of burnout at a 9% increase in likelihood of satisfaction among physicians.
Two Proposed Solutions to Reducing Physician Burnout
There are at least two core components needed to facilitate a solution to the burnout crisis.
Conscious Leadership Training for Healthcare Leaders
The first solution involves training healthcare leaders in developing greater awareness and social and emotional intelligence, also known as, “Conscious Leadership.”
Conscious Leadership is a term coined by Conscious Capitalism®, an organization founded and engaged in by member companies like Starbucks®, Whole Foods®, Trader Joes®, Southwest Airlines® and Patagonia®.
The mission of Conscious Capitalism® is to “elevate humanity.” Its four principles are: 1) higher purpose guides the work, 2) all stakeholders are considered, and 3) conscious leadership cultivates 4) conscious culture and a thriving enterprise.
Companies subscribing to the model have been shown to outperform on multiple business metrics of business performance.
The principles of Conscious Capitalism® are transferable to healthcare, where the development of conscious leaders has never been more important.
The development of conscious healthcare leaders cultivates the personal and systemic awareness needed to address the overwhelming stressors facing healthcare. It will also facilitate developing healing, resilient and thriving cultures with the higher purpose of delivering high quality compassionate healthcare—for all stakeholders, including patients and healthcare providers.
Resiliency Training for Healthcare Providers
The second component requires that healthcare leaders and their institutions prioritize self-care by offering sustainable burnout prevention and resiliency programs to healthcare providers so they can develop their inner resources to meet the tremendous demands they face.
We need to go beyond the traditional approach of merely providing opportunities to acquire CME’s and to keep abreast of new developments in their specialty area to now focus more on supporting and providing interventional training that integrates Conscious Leadership with programs that promote healthcare provider resiliency and well-being.
Many healthcare professionals are super high achieving, driven, caring, somewhat perfectionist personalities who are relatively healthy, self-aware and emotionally intelligent.
However, they have also been conditioned through a rigorous, brutal, bullying mentality at medical school not only to put others’ well-being before their own, but to constantly appear alert, authoritative and mentally sharp, despite being overworked, sleep deprived and wrestling with self doubt.
Overwork and self-sacrifice may be considered by others to be a rite of passage (pulling 36 hour on-call shifts, for example), but this takes a toll over time.
Combine chronic sleep deprivation with, say, excessive hours worked, loss of autonomy and control over your schedule, eroding compensation levels, excessive clerical duties from too much paperwork and entering reams of data into electronic medical records and you get depressed, disengaged clinicians, and burnout on a massive scale.
This is toxic to any workplace.
But there is much we can do and it must start from the top of the healthcare hierarchy: from healthcare leaders who value their human capital as much, if not more, than the bottom line.
Leaders who invest in cleaning up unhealthy, toxic workplace environments can find easy inexpensive ways to re-engage their workforce and provide authentic, compassionate leadership so their staff feels cared for.
It requires a mindset “reset” for leaders and healthcare providers alike.
One of the best ways to do this is through mindfulness-based leadership and resiliency training for both groups.
Mindfulness Training Works
Mindfulness is a remarkably powerful and scientifically proven practice for cultivating greater awareness and social and emotional intelligence. It has been shown to actually re-wire your brain in ways that can promote greater resiliency, engagement and performance.
Mindfulness can help to cultivate skills and qualities that are key to high performance leadership and high quality patient care including:
- navigating stress;
- cultivating empathy and compassion;
- building focus and concentration; and
- improving decision making.
Studies have also shown that mindfulness-based programs can reduce burnout in healthcare providers.
For example, a 2014 study of 74 practicing physicians at the Mayo Clinic who were randomized to 19 biweekly sessions including mindfulness, found that clinicians experienced a reduced sense of depersonalization and an enhanced sense of meaning and engagement. These results were sustained over 12 months.
Further, a rigorous review (including 8 randomized studies) published in 2016 in The American Journal of Occupational Therapy concluded, “There is strong evidence for the use of mindfulness practice to reduce job burnout among health care professionals…”
Knowledge is Power But Only Implementation Creates Change
The epidemic of burnout demands new solutions, and the time is ripe to implement mindfulness training throughout healthcare organizations.
We have the science to know what works to solve the problem. We just need to implement and integrate it on a large scale within every organization.
Education and training in mindfulness-based conscious leadership would accelerate adoption throughout the organization as well as improve leadership performance – and by extension, help to reduce burnout.
Engaging employees and demonstrating a commitment to culture change by providing resilience training for staff, including all physicians and those flagged as most burnt out – nurses and auxilliary client-facing professionals – will result in improved staff morale and less burnout throughout the healthcare system.
If conscious leadership training is integrated with robust mindfulness-based resiliency training throughout the healthcare organization, it will go from being a good idea to actually get “wired in” practically and result in sustainable change.
If we want to start making a dent in the epidemic of physician and healthcare provider burnout, see increased well-being, deeper relationships, more effective leadership and a more compassionate and productive workplace inside our healthcare institutions, then integrating conscious leadership with mindfulness training at an organizational level is a good place to start.