The Business Case for Investing in Physician Wellbeing - a Dual Competitive Advantage for Early Adopters

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In 2017 an article in JAMA Internal Medicine by Shanafelt, Goh and Sinsky (JAMA Intern Med. 2017;177(12):1826-1832) made a comprehensive business case for investing in physician well-being. I highly recommend the article. The UCSD HEAR Program has mounted the full PDF document at this link. I recommend you read and absorb every word.

In this blog post let me show you a different way of looking at the benefits to the organization of taking better care of your physicians and staff. 

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The Current State of Affairs

For the individual physician burnout can cause emotional and physical exhaustion, compassion fatigue, cynicism, loss of a sense of purpose in their practice, depression, alcohol and drug use, divorce, shortening of their career and even doubles all physician's risk of dying of suicide - regardless of their gender.

Organizational symptoms of burnout include decreased quality of care and patient satisfaction, higher medical error rates, higher rates of malpractice suits, physician disengagement, dissatisfaction and disruptive behavior and higher turnover for both physicians and staff.

Remember too that burnout prevalence in US physicians in the last 4 years or so has hovered at 50% or more regardless of what group of physicians have been surveyed. Now notice something else ... 

How is it you can read those paragraphs and NOT BE PULLING YOUR HAIR OUT and telling your friends and family not to go to the doctor or hospital until we FIGURE THIS OUT?????

All doctors practice medicine from within the center of a powerful whirlwind

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This is Blog Post #278
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Your practice is a mini-tornado of:

• Repetitive actions with your patients and staff
• Thousands of clicks and keystrokes in documentation
• Competing demands for your attention from email/text/voicemail
• And dozens of decisions, some of which actually involve life and death

And that's a slow day ... right?

It is a legitimate whirlwind - a Dorothy-on-the-Kansas-prairie twister that can tie you up in knots and even make you forget you forgot lunch ... sometimes. That same whirlwind is a core cause of physician burnout too.

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How is Your Whirlwind Feeling These Days?

You get to decide how satisfied you are with your practice. You can do that right now quite simply - even though you have been conditioned to NOT ask yourself questions like these:

Physician Burnout Key Personal Defense Skills Podcast - Complete Your Medical Education 

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Lower your stress levels, build more life balance and a more Ideal Practice. Complete your medical education and learn to recognize and prevent burnout in yourself and others.

Had a really good first conversation with Taylor Brana over at TheHappyDoc. In it we go over a number of the basic patterns in burnout risks and burnout prevention we have learned in our work with thousands of burned out physicians in our coaching practices. Great to be able to share and Taylor is allowing me to mount the podcast here on our website as well. Enjoy,

TRANSCRIPT:

Stop Physician Burnout - Treating the Symptoms only Makes Burnout Worse

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This is Blog Post #276
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Physician burnout has two sets of symptoms

• One for the Doctor - the personal signs and symptoms that YOU are suffering from burnout as an individual

• One for the Organization - the various way rising levels of physician burnout destroy the performance and morale of a population of healthcare providers

For the individual physician, here is one of our most popular posts on burnout's symptoms and gender differences.

In this blog post, let me show you three quick observations from our work with over 140 healthcare organizations and societies to date:

• The common organizational symptoms of burnout
• How and why most groups only treat the symptoms of provider burnout
• And why just treating the symptoms inevitably makes everything worse

"We can't talk about physician burnout, everyone will go part time"

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This article kicks off a mini-series of blog posts documenting my experience of Silly Things Physician Leaders Say About Physician Burnout. This first example is a great place to begin - a surprisingly frequent CMO/CEO exclamation - often used as justification for continued attempts to ignore the obvious presence of physician burnout.

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"We can't talk about physician burnout, everyone will go part time"

That is a major subconscious fear of some healthcare administrators and physician leaders. Sometimes they will actually say these same words to your face. If you happen to be the wellness champion in your organization, that statement is usually part of a paragraph that includes "things were OK around here until you showed up".

Physician Leadership:
A Simple Communication Tool to Avoid the Disruptive Doctor Label (video training)

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If you invite physicians into your management or leadership meetings, we will diagnose the problems in the system of care with the same speed and skill we diagnose disease in our patients.

Sooner or later we will also run into any number of situations that qualify as hypocrisy: where the organization says one thing and does something completely different.

Nothing in this world upsets a physician leader more than hypocrisy. 

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We see it right away, like a flashing red light. It drives us to shout, thump tables, foam at the lips and more. This undisciplined behavior results in many doctors being labeled a "disruptive physician" and their completely legitimate concerns downplayed or ignored by the other senior leaders at the table. This outright dismissal of legitimate concerns can be a major cause of physician burnout for some doctors.

Here is a Simple Communication Tool to Completely Avoid Being Labeled Disruptive and get your concerns addressed.

Maternal Discrimination in Medicine - Blatant form of healthcare gender bias documented in two new studies

Two studies released this week felt like dueling head slaps as they rolled through social media. Both document a slight twist on the typical gender bias against women that is pervasive in the world of medical education and the practice of medicine.

These two studies were not just about healthcare bias against women for being women - the "Curse of the Double X" I have written about before. This garden variety gender bias plays a huge role in physician burnout for many women physicians in my coaching practice.

These articles lay out a different flavor of bias against women - specifically because of a super power most carry at all times. I am talking about the THREAT OF FECUNDITY.

I always make a point of asking the women physicians at our live trainings if any man has ever said this to their face, "I don't know why we let women go to medical school, you are just going to quit and have babies."

How many say, "Yes"?

Everything should be made as simple as possible, but not simpler.
~ Albert Einstein

[ The Quadruple Aim Physician Leadership Retreat is Here ]

Physician Burnout - Praying for a one-step solution is human nature and a trap!

One of the key features of physician burnout - or any supremely uncomfortable life circumstance - is a desire to run away, escape, make the pain stop. When you are deep in the downward spiral, your mind drops to its knees and prays for a simple, one-step solution to the agony and despair.

We ask basic questions like:

1. What can I do to fix/stop/solve this?
2. How long will it take?

Because our questions are simple, we assume a simple answer will come to our rescue.

That is the first mistake - especially if you are a physician leader looking to prevent physician burnout at a system level. 

We almost always ask the wrong questions.

In this blog post, let me show you the simplest way possible to prevent physician burnout in any healthcare organization that employs physicians. I promise to make it as simple as possible for you, but no simpler. 

THREE KEY DISTINCTIONS

Stop Physician Burnout - Wall Street Journal Article Insults the Plight of US Doctors

This week the Wall Street Journal (WSJ) assigned a staff writer to pen an article on physician burnout. "Hospitals Address Widespread Doctor Burnout" came out on June 9th and IMHO it would be hard to do a worse job of bringing the American public up to speed on the modern burnout epidemic.

Given that physician burnout is the single biggest threat to the health and wellbeing of both the physicians and patients - the atrocious quality of this article is an insult to the healthcare profession.

The real tragedy here is what happens when a burned out doctors sees the issue handled in this manner in the national press. It becomes even easier to give up hope, since no one appears to be taking your concerns, your exhaustion, your heartbreak - even your impulse to abandon medicine altogether - seriously.  

Don't give up just because the WSJ and this writer have never spoken to a burned out doctor and don't have the first clue what they are talking about. There is ALWAYS a way forward 
- Our coaches are always available here
- The MATRIX 2.0 is here

Reading such drivel ... on such a stage ... realizing the WSJ just totally blew an opportunity to inform the public on the nature and impact of the plague of physician burnout ... is infuriating. 

The article staggers randomly from superficial point to silly quote for just long enough to become truly annoying.

Here are the key take aways from the writers perspective. BTW, if these highlights seem lame/vapid/superficial ... you are beginning to understand just how bad this article is.

Physician suicide is the most extreme complication of physician  burnout, yet suicides often fly under the radar

Physician suicides are taboo subjects, quickly swept under the rug and subconsciously banned from civilized conversation ... until ... someone popular and famous and well-loved dies in a highly visible suicide. This week it was Anthony Bourdain, author of Kitchen Confidential and host of his Parts Unknown TV series. 

While the world mourns Bourdain, the natural tendency is for all of us to remember someone we lost to suicide in our own lives. For doctors, the person we remember is often a colleague. The whole issue of doctor, resident and medical student suicide gets lost in the larger conversation about the tidal wave of physician burnout. The sad truth is that physician suicide is a known complication of physician burnout and ... 

Whether you are male or female, choosing to become a doctor immediately doubles your suicide rate. 

As the world mourns the unexpected loss of Bourdain, my heart mourns for those doctors, doctors in training, nurses, EMT's and other healthcare workers who also took their lives ... the people whom only you and I remember.

Four Reminders and Action Steps to Prevent Physician Suicide in wake of this week of tragedy: