It's not Physician Burnout dammit - it's Moral Injury, Victim Shaming, Human Rights Abuses, Right?

There is a wave of righteous indignation sweeping the online discussion of physician burnout recently. It is spawning a series of increasingly outraged new terms to define burnout as a symptom of systematic, deliberate abuse perpetrated by "the system".

Some even go so far as to accuse physician burnout coaches of "cannibalizing the corpses of their colleagues" - one of the more inappropriate and creepy examples of alliteration I have heard in a while. But hey, jump on the bandwagon.

When managers/leaders drive for production in the face of physician burnout ... this becomes the leadership lesson of the day.

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Unfortunately the absence of empathy and understanding is something the same physician leader is often completely unaware of.

Stop Physician Burnout - 4th grade math shows the epic fail of the current practice of medicine

We don't need no stinking spreadsheets

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Let me show you a simple, reproducible, fourth grade math demonstration of the power of team based care and up-staffing the back office. Along the way you will begin to sense the staggering waste in the current practice of medicine, caused in part by industry standards like the MGMA annual staffing survey.

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The reason EMR is killing doctors is simple -- OVERWHELM

Doctors were never meant to handle both
1) the complex interactions and thought processes of diagnose and treat, teach and manage patients
2) AND the digital documentation of those interactions via any one of the current truly demonic user interfaces.

The implementation of EMR doubled the workload on the doctors.

Most employers did not staff up to handle it. Instead, relying on annual staffing surveys to show them the average back office staffing ratio is the same as it was back in paper chart days - 1 Doc + 1 Medical Assistant. 

That's right, the work load doubled without a change in the number of hands on deck.  The documentation falls on the doctor simply because:

- we are ultimately liable for what is in the chart
- we don't punch the clock and stop working at 5PM

It is as if someone designed the system of care specifically to burn out doctors and now they use industry averages to reinforce the travesty. You can't design a more perfect meat grinder for the average doctor and now it is considered the standard of care.

The result:

• Two hours in the chart for each one hour of face time with patients - "Pajama time"
• Burnout rate in US physicians hovering at 50%
• It's a healthcare delivery failure of epic proportions

A 4th Grade review of the numbers reveals a way forward

Putting pen to paper in a personal journal is a powerful burnout prevention tool for doctors ...

- and the research says a keyboard is not a substitute for pen to paper.

The unexamined life is not worth living ~~ Socrates

The palest ink is better than the best memory ~~ Chinese proverb

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One of the best ways to step out of the whirlwind of your daily life is to develop the habit of journaling about your experience.

Every single time you pick up your journal you put a process in motion that supports you building a more meaningful life and and practice. Writing in your journal automatically transports you to a new perspective, outside the whirlwind of ordinary events.  You pause and reflect.

The notes in your journal come from a new level of consciousness rather than the day-to-day rat brain of survival. Problems and dilemmas can be seen much more clearly and new action steps stand out like neon lights. 

No problem can be solved from the same level of consciousness that created it ~~ Einstein

It all happens so fast it is easy to miss the power of process. Let's slow things down and take a closer look.

Here are the steps to journal self-reflection:

When burnout forces you to reverse the bad habits of our training - normal self-care can seem like an act of courage

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Burnout is your destiny trying to get your attention. It's objective - wake you up and knock you onto a path with more purpose.

Most of the time, it must grind you to a state of complete exhaustion, before you will begin to challenge the habits that got you here. Those survival habits were learned in the crucible of your residency. Learning to take better care of yourself won't come easily.

And if you are lucky, burnout finally gets you to look in the mirror and ask, "Is THIS what I really want in my life and my practice?"

If you recover, better self-care will be a significant piece of your strategy. You realize you don't have to live your life like a resident. There are other options.

• You will learn how turn off your "the patient comes first" programming when you are not at work
• You will find new ways to take better care of yourself - to put your mask on first
• Rest - Nutrition - Vacations/Holidays - even a little pampering here and there - will all play a role. 

Then you run into the next obstacle. 

As soon as you start taking better care of yourself, GUILT will often rear its ugly head.

The consensus is clear, EMR and documentation overload is the single largest source of stress for most physicians.

How did it come to this?

Because forcing physicians to both take care of patients AND perform as a data entry clerk is bad for everyone involved - the patient, the doctor, the doctor's staff and family ... EVERYBODY.

We already have studies showing two hours of documentation chores for every one hour of direct patient care. This documentation disaster already has a slang term for its ability to destroy doctor's family life - "pajama time".

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In this blog post let me show you:

• A single graph that perfectly expresses the overwhelm, specifically for US doctors - check it out
• Four reasons why this is happening, specifically to US doctors
• Four ways to immediately ease your documentation workload - things you can do now, rather than wait for the EMR industry to fix itself
  
  

1) A Single Graph that Says it All for US Doctors

Last week, the major healthcare organizations in Massachusetts all agreed that the physician burnout epidemic is a public health crisis ...

... and then missed the mark with their recommendations. 

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The Mass Health and Hospital Association, Mass Med Society, Harvard T. Chan School of Public Health and Harvard Global Health Initiative published a position paper titled: 

"A crisis in health care:
A call to action on Physician Burnout"

What took them so long you might wonder. 

Since they are coming late to the party, you would expect they will rock the RECOMMENDATIONS section of their White Paper, right?

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In this post, let me use the sharp edge of our 10,000 hours of real world experience treating and preventing burnout with 163 client organizations to date --

... to show you exactly how the four main recommendations of this consensus statement of academics Miss the Mark.

I can assure you things are a little different at ground level than they may appear from a literature review in the ivory tower. 

Let's Dive In. 

Primum Non Actio Stupidus

• STOP making the doctors and nurses do stupid things

• If you want to know what these stupid things are ... all you have to do is ask the doctors and nurses

Primum Non Actio Stupidus

In about one hour, answering these 10 questions can make 2019 your best year yet

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What would it take to make 2019 YOUR Best Year Yet?

Take a single hour now to fill out the Physician's 2019 Breakthrough Process Worksheet -- and watch the difference it makes ...

DOWNLOAD, SAVE and PRINT OUT the .PDF worksheet below get started. It just takes an hour about an hour to answer the questions --- automatically setting you up for an incredible year ahead. Take a quiet moment this weekend, with a cup of your favorite tea, to fill out the pages and start building your 2017 breakthrough.

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Thank you so much for allowing us to serve you and learn from you in 2018.

Peace, Rest, Gratitude to you and your family in this Holiday Season!

Here are three blog posts tailor made for the holidays.