A recent burnout prevention training for residents revealed the importance of the teachable moment for their future employers.

Here's how I learned this important lesson:

There are some things doctors can't really learn until the time is right -- and residency may not be that right time -- no matter how much we wish it was.

I just delivered a half day retreat for a group of residents a large east coast independent academic medical center. In planning the event, I sifted through my experience coaching hundreds of doctors who burned out after residency ... when they were in practice. I was looking for a short list of skills to answer this question:

"Given what burns out practicing physicians, what can I teach these residents now that could prevent their burnout in the future?"

Back to the future

Basically I envisioned myself as a representative of these residents future selves, coming back to teach them the tools they need to avoid physician burnout when they are out in practice.

• So I put together a three training, four hour event
• Delivered the trainings
• And watched carefully to see how they landed with the residents
• What were they able to pick up and use right away?
• What concepts/tools went over their head?
• What appeared to useful and what appeared to be useless at this point in their careers?

My experience gives us all some information to answer the Teachable Moment Question:

Is residency the best place to teach the tools to prevent burnout from happening when these doctors are out in practice?

Or is there a better teachable moment?

Will recent recommendations of the National Academy of Medicine cause meaningful action to address the burnout epidemic?

• Will we look back 10 years from now and say 2020 is when everything changed?
• Do calls for a "positive work environment" mean anything when there are no recommendations on HOW to accomplish that feat? 
• What happens in the C-suite when this call to address physician burnout clashes with the organization's drive to maximize profit and shareholder value? (even non-profits must have a margin!)

In this blog post let's do two things:

2) Give you a copy of the full recommendations so you can do two things:

1. 1. Print off two copies and carry them with you at all times.
   2. So when the opportunity arises, you can drop them on your CEO/CMO/CFO's desk and ask that they be adopted in your organization. If your boss can be influenced by consensus statements like this, you want to be ready for their teachable moment. 
      

Toss the New Year's Resolutions ... these ten questions can make 2020 ... your Best Year Yet.

Wrap a bow around all your accomplishments and milestones for 2019.
Give yourself a solid pat on the back.
Then, set your intentions for 2020.

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No rush. Grab the worksheet download with the link below and print it out.
You will have plenty of time to work the questions at your leisure in the week
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This is our fifth year sharing the Physician Breakthrough Process

Here is Dr. Zubin Damania's take on the intersection of happiness and the experience of being a hospitalist

Please Leave a Comment 

How does his message and his story resonate with you?

Will the government step in and legislate proactive efforts to stop physician burnout?

As we predicted several weeks ago, it is only a matter of time before the cry for legislative action would go out. And rightfully so:

• Physician burnout has been characterized as a public health crisis for years
• Given the negative effects of burnout on safety, quality, medical errors and physician's mental health ... it is clear that unrecognized burnout kills patients and doctors
• The prevalence of burnout is staggering here in the age of EMR - over 50% in many studies
• And the majority of healthcare organizations who employ doctors make no meaningful investment in physician wellbeing. Lip service is rampant, but significant FTE and dollars for burnout prevention are exceedingly rare.

Sooner or later, someone was bound to shout, "there should be a law about this." That non-specific call for action happened here back in July.

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Let's take it up a notch

Now we have specific calls for specific carrots and sticks from a bona fide legal scholar.

Sharona Hoffman, , JD, LLM, SJD; Professor of Law and Bioethics at Case Western Reserve University, has written an editorial in the latest Hastings Center Report

Why is it so darn difficult for people to see you are a good doctor these days?

We both know you are a good doctor. When it comes to diagnosing and treating your patient's diseases and chief complaints, you do a great job. None of us devoted our 20's to med school and residency to be a crappy doctor, right? 

So why is it so hard for the patients to see that when they are filling out their patient satisfaction surveys?

Why is there such a disparity between your efforts to offer the best medical care and their Press Ganey scores??

ARRRGGHH...

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It takes a while for most physicians to understand the source of this double standard. That is why this whole topic of patient satisfaction is a core cause of physician burnout.

Sooner or later all of us must admit ...
When it comes to the cursed gap between the quality of your Practice of Clinical Medicine and your Patient Satisfaction scores ... 

Your patients can't tell a good doctor from a bad one.

The adoption of the Electronic Medical Record is a clear and obvious cause of physician burnout.

This new study provides three new data points for both providers and healthcare leaders:

• Evidence of a dose response curve between EMR exposure and physician burnout
• Objective measurements of EMR usability compared to other unpopular software programs.
• And an actual letter grade from physicians for EMRs as a group.
  (No surprise here - EMR gets a big fat "F") 

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This is all an avoidable tragedy
EMR should have never been a major burnout cause 
It should have been a simple staffing issue
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We consider this paper a MUST READ for all C-Suite Healthcare leaders, Chief Wellness Officers and Wellness Champions

We read the study so you don't have to!
Highlights and commentary below --

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Study Highlights

"Everybody is a Genius.
But If You Judge a Fish by Its Ability to Climb a Tree, It Will Live Its Whole Life Believing that It is Stupid"

~ Albert Einstein (?)

The first time I saw this quote two things became clear to me in a flash.

• The logic behind the quote is undeniable
• AND the author is obviously talking about physicians and the Electronic Medical Record

Every week I talk with CMO's and other senior physician leaders who simply cannot understand why some of their doctors "struggle to get out of the room,  stay on time,  see a minimum number of patients per day, over-charting" and more. 

And every week we meet hard working doctors who are haunted by the simple doubts, "what is wrong with me that I can't get my charts done?" and with the next breath, "I'm not sure how much longer I can keep going like this."

This stand off is smack in the middle of a gaping blind spot we see in nearly every healthcare organization. 

Practicing Medicine
and Data Entry into an Electronic Medical Record
are two separate skill sets
(And one of them is WAAAY more important than the other)

QUESTION:
Is it actually some sort of inscrutable riddle, a conundrum, a freaking MYSTERY why doctors struggle with the Electronic Medical Record and other digital forms of overload??

The answer is simple:

Many leaders are judging a fish by its ability to climb a tree

Forceful patient requests for antibiotics in an obvious viral URI are some of the most difficult conversations for any doctor to handle.

• On one side - the patient is miserable
• On the other side - the diagnosis is simple and quick and the treatment is crystal clear

Yet, in many cases, we physicians can be persuaded to prescribe against our better judgement. 

• Where does this common patient-doctor conflict originate?
• Who can shed light on the awesome persuasive power supplied to our patients by a simple rhinovirus?

I nominate Ogden Nash.

Read his poem below and remember your last doozy of a head cold. I nominate these sentiments, rarely spoken in the course of your office visit, as the source of the arm twisting power of your sniffling, suffering patient's argument for antibiotics.

Enjoy ... 

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"Common Cold"
by Ogden Nash

There is plenty of evidence that Physician Burnout has a negative effect on a doctor's quality of care

Make's sense, right?

If you are a physician who is

• exhausted
• cynical and sarcastic
• and doubting that your work is making a difference

- BTW, these are the three cardinal symptoms of burnout - 
If that is the way you are feeling today at work, you care clearly not on your "A" Game as a clinician and healer ... right? Oh yes, and in the average healthcare workplace, 50% of the doctors are suffering from at least one symptom of burnout on each practice day.

The question for physician leaders is a simple WHY?

Why are so many of your doctors burned out?

Please don't doubt their Resilience.

Physicians are some of the most resilient people on the planet. We survived residency for heaven's sake. That should be all the evidence you need of our ability to take a lickin' and keep on tickin'.

• We are some pretty tough CANARIES.
• What is it about your COAL MINE that is taking us down?

Yes, burned out doctors provide lower quality care.
And I invite you to dig a little deeper. Notice that the doctor's level of stress and burnout and the quality of their care are in a reciprocal relationship.

The burnout - quality of care link is actually a CHICKEN AND THE EGG CONUNDRUM.

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Which of these comes first?