This Insight was updated January 10, 2018 to provide new information on the topic of physician burnout.
As an oncologist, I’ve fully experienced the many personal rewards and fulfillment that comes from caring for patients with cancer. However, this can also come at a price. Cancer specialists frequently deliver bad news, administer toxic treatments, and care for patients suffering from diseases that they may not be able to cure. Not surprisingly, studies have indicated that burnout is a real risk among cancer care professionals. However, oncology is not the only clinical field where burnout is an occupational risk. A growing number of studies and reports show that burnout among physicians in all specialties is on the rise and threatens to reach ‘epidemic’ proportions. Burnout has serious negative implications for both the physician and the patient. One example is the ‘depersonalization’ that often accompanies burnout, which can have a negative impact on patient experience through a lack of empathy and attentiveness to the patient’s needs. Burnout can also lead to increased medical errors, decreased productivity, professional misbehavior, substance abuse and in extreme cases physician suicide.
Fortunately, there is good evidence that leaders can play a significant role in enhancing physician engagement and mitigating burnout. A study on the influence of leadership on burnout showed that particular qualities of clinical leaders appeared to have an impact on the well-being and satisfaction of individual physicians working in health care organizations; specifically, with leaders who informed, engaged and empowered those that they led.
Engagement and burnout are on opposite ends of the spectrum. When physicians are engaged they are more resilient to stress and burnout, and the converse is equally true. By making a practice of rounding on individual physicians, leaders can learn what is most important to their physicians and better understand how the organization may support their goals. Working with physicians on developing systems of care that provide them with flexibility and a sense of control over their work environment is also essential. This level of engagement enables leaders to build true partnerships with physicians and profoundly change the nature of their relationship, leading to increased commitment, dedication and loyalty. At the end of the day, physicians who feel that they have been given the support necessary to deliver the quality of care that their patients require are more likely to be satisfied with their practice.
Clinical leaders can also borrow lessons from the team-based model of care highly promoted in progressive health care systems. Studies show that effective teams reduce burnout by providing clinical and personal support for each team member. Shared task-work, such as that exhibited in multidisciplinary cancer care, is critically important for preventing burnout through the allocation and distribution of services throughout the team to best meet the variety of patient care needs. Leaders can promote a culture of collaboration, interdependency and mutual respect within members of the care team. This includes enhancing interpersonal dynamics by supporting activities that build strong collegial relationships and promptly resolving workplace conflicts.
Finally, clinical leaders can help physicians remember the rewards and privileges of patient care that first drew them to the field. Organizing inspiring events, sharing encouraging patient stories and celebrating team progress can go a long way to help prevent burnout and enhance engagement.
10 Practical Tips for Clinical Leaders:
- Make time regularly to round on physicians and have discussions about stress-related issues. Talk with those who have experienced a stressful event in the workplace.
- Conduct team meetings for problem solving and conflict resolution.
- Invite all members of the team to discuss expectations and preferences for daily patient care operations.
- Seek to create systems where physicians can practice ‘at the top of their license’, without being limited by activities more appropriately handled by other members of the team.
- Address issues of process improvement (e.g. optimizing patient flow in clinic), which can increase efficiency and allow physicians to spend more time with patients.
- Work with physicians to develop practice models that can facilitate and accommodate for life events (e.g. flexible scheduling)
- Arrange for training in mindfulness, conflict resolution, and patient-centered communication. Clinicians with proficiency in these skills have reported lower rates of burnout.
- Recognize success and celebrate progress. Recognition in front of peers for a job well done can be a tremendous ego boost and go far toward stemming the onset of burnout.
- Encourage physicians to prioritize self-care as an element of medical professionalism.
- Ensure that metrics for institutional success include physician satisfaction and well-being.