I realize that an either-or question is not usually answered with a ‘yes’. But, my point is that there is a problem in the way that this question is framed. And that is imminently understandable, as many proponents of healthcare improvement strategies often fall into one or the other frame of reference. CEOs and many business consultants are oriented from the leadership paradigm, and naturally look to enhance engagement with their physicians and nurses. This is an imperative in making healthcare delivery more functional. From the physician’s perspective, however, the focus has traditionally been from the orientation of diagnosing and treating burnout. This is equally critical in moving to the next step. Further, the literature of ‘Burnout’ is filled with research and input from physicians. This is very natural because physicians have little ability to control the amount of engagement that CEOs are willing to extend to them. Those healthcare systems with truly engaged CEOs are a bonus.
The analogy that I like to use in this regard relates to an event in American history. In the 1860s, the transcontinental railroad was built by two separate companies. The Central Pacific RR laid their rail from Sacramento moving eastward, and the Union Pacific RR laid their rail from Omaha moving west. The convergence point was achieved in Promontory, Utah in 1869. Both railroad companies were working on exactly the same project, just coming from different directions. Synergy was achieved when the lines connected. The project was not achievable without cooperation of both parties.
My observation is that much of the work of treating and preventing burnout is being done around North America in ‘silos’ with only a modicum of high-visibility interactivity. Excellent work is being done, often imprinted with the mold of individuals’ expertise, but I sense that a greater degree of ‘cross pollination’ would enhance the efforts. Economies of scale could be achieved and the learning curve could be shortened by a dialogue of shared experience.
It appears to me, as much work is being done by ‘centers of excellence’ (Mayo Clinic, Vanderbilt, Rochester NY, U of Virginia, Portland Oregon, U of Massachusetts, among others), other individuals around the country are looking at the plethora of information of burnout and wondering ‘how can we develop a program to foster engagement and prevent burnout locally?’.
This singular question, whether fully articulated or not, is on the lips of all individuals in healthcare who are experiencing the existential crisis of burnout and wondering what to do about it. I think that the Studer Group website provides the best opportunity for such a dialogue, sharing of best practices, and development of strategies to deal with the healthcare crisis in our midst. It is to this goal that I am extending my best efforts.
Stay tuned for more to come.
George A Ford III MD FACP
Visit StuderGroup.com/Burnout to access research, literature and provide feedback on burnout.
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