Stop Physician Burnout - the Pandemic Profit Crater & the Sine Wave Delusion

Posted by Dike Drummond MD

physician-burnout-prevention-video-opt-150w-5Let me show you a classic bean counter leadership delusion that is already increasing front-line physician burnout here in the USA.

The Sine Wave Delusion happens when a physician leader does not understand patient care and assumes financial losses can be made up easily if we just spin the doctor hamster wheels faster. 

In this short video let me show you
=> the Crater,
=> the Delusion,
=> the tragic Impact
=> and what you can do about it.

The Pandemic Profit Crater and the Sine Wave Delusion

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  • Are you seeing your leaders buy in to the Sine Wave delusion?
  • How is this effecting Your Practice?




Stop Physician Burnout: The Pandemic Profit Crater and the Sine Wave Delusion

Hello again Dr. Dike Drummond here from the home of in beautiful Seattle, Washington. I've got an important trend that I want to show you that I'm seeing in the healthcare industry that's driving doctors to higher levels of burnout here in 2020 as we wind into the later phases of the covid 19 pandemic. Let's look at it though from outside the whirlwind. I know every doctor in their practice is in a monster whirlwind distorts your worldview. So let's pop out of that whirlwind right now. Big breath in with me. Yeah, take a big breath. And as you exhale, let go of anything that doesn't need to be here right now.

And pop yourself out of the whirlwind.

So we can look at your practice, and we can look today at trends in the healthcare industry, from this new perspective. This trend I call the pandemic profit crater, and the sine wave delusion. It's about physician leadership and a way that bean counter leaders in the healthcare industry are using an old mathematical formula to burn out doctors very effectively here as our practices wind back up to normal volumes. Check it out.

You remember a sine wave, right? Probably from your undergraduate studies. Let me draw you one right now. It's a thing of beauty when it's done with a mathematical formula, a beautiful arc that's just as big and curve below as it is above the line. And in a sine wave. What happens is the volumes above and below the line are equal. Well, this this looks a little bit like what's happened to the income in the healthcare industry in the United States here in 2020.

Beginning of the year, things were at normal volumes By the way, this straight line also represents doctors normal levels of production, normal levels of patient volumes and RVU’s.

And I want you to remember that at baseline, the normal level of physician production in the United States was producing a baseline rate of physician burnout of 40 to 50%. 40 to 50% of doctors were burned out even at this production level.

And then along came COVID-19. In March of this year was when it first started to bite in Seattle.

One of the things that a lot of people don't understand is when we saw the news full of overwhelmed emergency room and overwhelmed ICUs we thought the whole industry was going gangbusters. But that was only 25 or 30% of the healthcare personnel. The doctors and staff in an integrated healthcare delivery system. 60 70% were slowed down further laid off, the patients weren't coming in.

So what ended has ended up happening was we had a patient profit crater in the second quarter of 2020. If you look back Mayo the Mayo Clinic wrote off $3 billion worth of income in March of this year, against a $13 billion total income in 2019. That's 25-30-40% less income in the quarter, a pandemic related profit crater in the first and second quarter of 2020.

Well, now what's happening we're in the later phases, patients are starting to come back in and see their doctors we virtually we've rotated to virtual and then back out into in person office visits. And the productivity in a lot of organizations is starting to come back up towards normal.

Here's where we get the sine wave delusion. Somebody who doesn't understand healthcare delivery taking care of sick patients interacting with families, the flow of patients and information through your office or through a hospital. They might remember a sine wave and think, “Hey, if we lost money in the second quarter, all we've got to do is spin the dribble wheel faster. And we'll make it all up into fourth quarter, right??

Wrong. Because another thing that's happening is I'm seeing CMOs and an operations officers and medical directors and leaders all throughout healthcare that are telling the doctors they must increase their production to levels they've never done before.

At the same time, the people in the organization are taking away vital frontline staff. They're right sizing the organization.

I've already had two members of my network quit because of this extra pressure. And I don't think they're going to be the last rats off a lot of these sinking ships.

So it is impossible. It is a fallacy a delusion that you can run the organization as far above normal, as it was not below normal in the second quarter. Physician volumes physician workloads are not elastic on the upside like that. And all you're going to do is burn your people out force a lot of turnover and make it miserable for everybody.

So what can be done?

If you're a leader -- know, the sine wave is a delusion. You will break your people if you think you can drive them over this hump in the fourth quarter of 2020.

Instead, I encourage you to get out of your ivory tower, get out of the office, go be with your people round on him, Shadow them. Say thank you. Ask how you can help and look for ways to remove obstructions to them are offering the best possible care to their patients.

If you're a healthcare provider, I encourage you to take excellent care of yourself. huddle with your team before you start seeing patients to smooth out your day. Make sure you have a good boundary ritual between work and home so that you don't take work home with you and take exquisite care of your physical physical and emotional need, spend time with your family as much as you can when you're not at work.

Just because the pandemic is winding down doesn't mean there isn't going to be pressure going forward on behalf of your organization to produce more than perhaps you ever have.

And that's why I always ask this question too. Do you think in the post pandemic period, that the health and well being of the providers of care will be more or less important? We both know the answer.

So come see us at We have tons of tools, retreats, all sorts of support services there for you. And don't let anybody try to drive you to the top side of the sine wave when we know that's not physically possible, especially if you're taking staff away. Okay, great. Take a big deep breath.

Have a great rest of your day.



Are you seeing your leaders buy in to the Sine Wave delusion?

How is this effecting Your Practice?



Tags: Physician Leadership, stop physician burnout, physician burnout video training, Pandemic