Cost of Physician Burnout to US Healthcare System = $4.6B per year - Is this useful information?

Posted by Dike Drummond MD

Physician Burnout may cost the US Healthcare System $4.6 Billion per  year, but does this data point help lower the stress of a single front line doctor?

 A new study out in Annals of Internal Medicine this week uses a cost-effectiveness approach to estimate the annual economic burden of physician burnout on the US Healthcare System. $4,600,000,000 per year was their estimate. The free floating anxiety in the headlines was palpable.

I just wish we could focus on useful research findings like Corey Lyon and his APEX Project ... and let's give real-world burnout prevention tools the same headlines as this fluff. 

I will classify this as an INTERESTING AND USELESS factoid.

I work directly with physicians and healthcare organizations every day to prevent burnout and am pretty sure this number is useless in my line of work. 

It is in the same category as knowing Pi to 10 digits (3.141592653) or how may toothpicks you would need to lay end-to-end to get from Milwaukee to Chicago (2,882,880).

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This highly-suspect projection has zero chance of improving the quality of life of a single front-line physician for the simplest of reasons ...

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Tags: Physician burnout, cost of physician burnout

Physician Burnout and the Four Phases of Compassion Fatigue

Posted by Dike Drummond MD

Compassion Fatigue is one of the psychological consequences of being a doctor

Losing the ability to feel empathy, sympathy and compassion for your patients is a constant risk for all of us.

This is a consequence of your choice to become a Lightworker years ago.

That choice guaranteed our exposure to the trauma, tragedy and agony of our patient's struggles. No one teaches you that compassion is a finite resource that must be regularly refilled or physician burnout is inevitable for all of us.

In this blog post, let me show you

  • why doctors are at unique risk for Compassion Fatigue and burnout ... it is the result of a decision you made long ago
  • how to recognize Compassion Fatigue
  • the four phases of Compassion Fatigue – where do you stand?
  • a specific method to restore your Emotional Energy Reserves and recover from your own Compassion Fatigue
  • and finish with a set of online Compassion Fatigue resources if you would like more tools or to study this important topic in more detail

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The Origin of this Lightworker’s Dilemma

Let’s start at the beginning
– the point in time where you chose to become a doctor in the first place

You remember that fork in the road?

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Tags: Physician burnout, compassion fatigue

Chief Wellness Officer - CWO - does your organization need one?

Posted by Dike Drummond MD

Chief Wellness Officer - CWO - does your organization need one?

It is all the rage in leadership circles these days. The mucky mucks are all in agreement. If your organization is serious about preventing burnout, the very first thing you need to do is appoint a Chief Wellness Officer - and watch the angry, dark clouds of burnout lift - revealing the rainbows and unicorns of a happy, healthy physician workforce.

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This is Magical Thinking of the highest order

Let's drink the CWO KoolAide for just a moment ... to recognize it is just another version of checking a box.

This C-Suite executive will be your savior, your cavalry cresting the ridge, your knight in shining armor, your hero among the bean counters. At the very least, they should be able to stop the rest of the C-suite from hammering the doctors into little tiny pieces.

Would your people or your organization actually benefit from installing a Chief Wellness officer - CWO

The answer of course is "IT DEPENDS"
[ And for 99% of healthcare organizations a CWO is a distraction from building a wellness program in the first place ]

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Tags: physician wellness, Physician burnout, quadruple aim, physician leadership retreat, physician wellness champion, chief wellness officer

Physician Leadership Lesson of the Day - Harm does not Require Malice

Posted by Dike Drummond MD

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.

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Tags: Physician burnout, Physician leadership lesson, quote, charles m blow, quotes

Investing in Physician Wellbeing brings a Dual Competitive Advantage

Posted by Dike Drummond MD

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?????

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Tags: Physician burnout, physician leadership, physician resilience, physician wellbeing

Stop Physician Burnout: Dealing Effectively with Negative Emotions

Posted by Dike Drummond MD

Stop Physician Burnout: Dealing Effectively with Negative Emotions

Like the layers of an onion, physician burnout is often wrapped in layers of negative emotions. In this post, let me show you a simple technique - it only takes 15 seconds - to release negative emotions as they arise and become the authentic eye of the storm in your practice day.

Peeling back the layers of the onion of bad feelings

If you find yourself overwhelmed, exhausted and out of balance with your practice -- after all your years of training and hard work, and this isn't anything like what you dreamed of back in the day ... well that recognition just feels bad.

And then you notice that the fact you feel bad about your career - well that feels bad too. 

[Related: Become the Eye of the Storm in your Practice Day]

Many physicians then begin to wonder about the source of this distressing situation. The little voice in your head might kick in by whispering:

What's wrong with you? You are a successful doctor. You have nothing to complain about. You can take this. Quit whining and get back to work. Your patients come first, dang it.

And if you do begin to take better care of yourself -- start creating a little bit of life balance and building some recharge activities into your week -- a different negative emotion often comes knocking at the door of your awareness ... GUILT.

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Tags: Physician burnout, mindfulness, release negative emotions

Physician Burnout Bibliography and Comprehensive Reference Library

Posted by Dike Drummond MD

The National Academy of Medicine just published the first discussion paper from their Action Collaborative on Clinician Wellbeing and Resilience

And it contains a hidden bonus for all Quadruple Aim savvy change agents.

It is a wide-ranging summary of the issue of Physician Burnout and its negative effects on all aspects of healthcare. 

It ends in classic academic fashion with a prolonged and detailed plea for more research.

Perhaps the most fascinating part of the whole paper is a comprehensive list of physician burnout study references - by far the largest I have ever seen. I share them with you here if you ever find yourself in need of a study to "prove" burnout's negative effects and convince leadership to take a stand for the Quadruple Aim.

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Tags: Physician burnout, physician burnout bibliograpy

Stop Physician Burnout - is Physician Resilience Training a "Con"

Posted by Dike Drummond MD

Stop Physician Burnout - is Physician Resilience Training a "Con Job?"

An article on physician suicide in junior Australian doctors this week contained the following bold statement:

'She was eaten alive'

The "con" of building physician resilience has left junior doctors vulnerable to mental illness and suicide by ignoring the systemic failures of the medical professionSpeaking at a session on mental health and wellbeing in Sydney alongside Health Minister Brad Hazzard, Ms Micaela Abbott said her sister was "eaten alive" by the medical profession. 

Dr. Chloe Abbott was 29 and a fourth-year doctor-in-training when she died in January, one of several recent suicides by doctors that prompted the Health Minister and the medical profession to act. 

"My family had really detested the term 'resilience'," Ms Abbott said, recounting her sister's fortitude as a champion swimmer who represented Australia in international competition. 

"That's not something you can do without resilience," she told the crowd of students about to join the profession that Dr Abbott's family and colleagues believed contributed to her death. "

Here is the full article:

It, of course, begs the question -- is the concept of Physician Resilience a con job to defend a hostile work environment?

The answer is Yes and No.

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Resilience is necessary but insufficient to prevent physician burnout and hard wire the Quadruple Aim into the workplace.

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Tags: Physician burnout, physician resilience

Physician Burnout - What to do When the Thrill is Gone

Posted by Dike Drummond MD

Physician Burnout - what to do when the Thrill is Gone

Remember back to your first clinical rotations in medical school ... how exciting it was to finally be face to face with live patients. Bedside conversations, recognizing skin lesions and the signs of CHF. What a thrill it all was. Remember?

How much does the word THRILL apply to your feelings about your practice ... now?

In the last month, how often did you say to yourself in a quiet moment, "wow, that was really cool" about a patient, a diagnosis, a procedure, a conversation with a family member or member of your staff? I sincerely hope you run out of fingers to count them all up.

However, if that is not true for you - if the thrill is gone or you can feel it slipping away - what can be done about it? Can you get the thrill back?

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Tags: Physician burnout

The Quadruple Aim - Three Components

Posted by Dike Drummond MD

Three Key Components of the Quadruple Aim

Medicine's new Quadruple Aim is the realization that building a quality healthcare delivery system is a lot like building a house.

If you have a good foundation, you can build a solid structure. 

If your foundation is unstable, weak or inadequate - your house will be in a constant state of falling apart. You cobble things back together, just in time for the walls to start crumbling again. 

If the "house" you want to build is a high quality, cost effective healthcare system with high patient satisfaction ... this is the old Triple Aim ... the only legitimate foundation is the health and wellbeing of the workers in the system.

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The Quadruple Aim IS the foundation of quality healthcare.

Every single contact with patients, test ordered, procedure performed and drug prescribed ...  is predicated on the assumption that your people are happy and healthy and enjoying their work.

Your ability to fulfill the promises of the Triple Aim is based on the assumption that your employees are at their best. Unfortunately we know that is measureably NOT TRUE. 

If your workers are burned out - quality and satisfaction go out the window and your system lurches from one crisis to the next. 

With recent studies suggesting that 50% of doctors are burned out on any given office day, the logical question is HOW?

HOW do you install the Quadruple Aim in your organization? 

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Tags: Physician burnout, quadruple aim


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