Organizational Changes, U.S. Healthcare Overhauls Needed to Mitigate Physician Burnout
Acknowledging this is a problem is the first step to making changes that help the workforce, patients and the bottom line.
Organizational changes are needed to mitigate physician burnout and other changes in health care.
After dealing with pandemic conditions, it has become clear that resiliency training for physicians will not address systemic issues contributing to burnout, said Michael Tutty, PhD, MHA, FACMPE, and group vice president for job satisfaction and practice sustainability for the American Medical Association (AMA). ). He outlined the latest research and potential solutions in the presentation, “Understanding and Addressing Physician Burnout in the Post-COVID Era,” 2022 Medical Practice Excellence Leaders Conference of the Medical Group Management Association.
It is true that the physical and mental well-being of physicians contributes to the feeling of burnout, characterized by:
- emotional exhaustion
- Feeling of diminished personal accomplishment and lack of empathy for patients
- Depersonalization, including cynical or negative feelings towards patients
But now is the time for doctors, staff and administrators to consider organizational overhaul and large-scale overhauls within America’s health care system, two larger systems that encircle the work of individual workers.
“I would say, though, that the best place to invest the time and resources we need is to work in the two outer circles, working on those environmental issues that make practicing medicine harder than it should be.” , Tutty said.
Studies have shown that doctors are more resilient than the general population. Focusing on the individual can feel like blaming individuals for not being resilient enough, “and we know that’s not the case,” Tutty said.
“It’s the organization,” he said. “This is the healthcare system we all work in. We all know how dysfunctional it is and how frustrating it can be. We know it’s not an individual problem.
One-on-one resilience training, like a mindfulness course, is great, but really serves as a coping mechanism when participants return to a chaotic work environment, Tutty said.
The AMA created the STEPS Forward program with practical lessons in the do’s and don’ts to improve medical workplaces. Tutty referred to this program and his “Saving Time Playbook” for more resources to alleviate conditions that contribute to burnout.
Here are some ways to start improving organizational well-being:
- Recognize the cost. The AMA has a calculator that can count the real dollar and cent effects of physician turnover, especially in larger facilities. “When you have a health care leader saying, ‘I don’t think we have the funds to work on this type of problem,’ the problem is, ‘Do you have the funds not to work on the problem? because of the coast to the institution,” Tutty said.
- Get feedback by polling the team. It seems that some leaders of organizations do not want to survey staff because they are afraid of the results. “Well, believe me, that’s how people feel, whether you poll them or not,” Tutty said. It’s a powerful tool, although Tutty advised waiting to read the results on Monday morning, instead of a Saturday morning so as not to spoil the weekend as the first impression can be overwhelming.
- Do a GROSS project. GROSS is Get rid of stupid stuff. “It’s not disgusting at all, it’s a pretty good idea,” Tutty said. He added that not all ideas need a study committee and that some ideas are so obvious that they should be implemented.
- Review the electronic health record (EHR) settings. Administrators might be surprised at the variations in documentation time among physicians. Physicians who spend more time on EHRs may need more training.
- Consider team-based documentation. Adding scribes to a practice can be expensive, but finding new opportunities in EHR documentation can free up doctors’ time while allowing other staff to get involved in patient care.
Tutty noted that email inbox messages have increased over the past two years for doctors, adding to job dissatisfaction. For email, EHR, and other computer programs, vendors tout the speed of programs, but if these add two minutes to the workweek, programs should cut two minutes elsewhere.
He proposed a four-question test to assess new technologies:
- Does it work?
- Will I receive correct payment?
- Will I be responsible?
- Will this work in my practice?
Build a team
Finding or implementing potential solutions for may not be as effective as you hoped, but could have a beneficial side effect. By working together to solve a problem, doctors and staff can create a camaraderie that’s powerful on its own, Tutty said.