3 weapons to battle physician stress

As doctors, you might be used to delivering the bad news first, so that's the sequence I'll go with. The first bit shouldn't come as much of a surprise: As a species, you're stressed. Specifically, 87 percent of U.S. physicians say they are moderately to severely stressed or burned out on an average day, according to a newly released survey conducted by Physician Wellness Services (PWS) and Cejka Search.

Across all of the hospitals, clinics, and healthcare organizations studied, the consequences of physicians' escalating stress and burnout range from risks to patient safety to poor staff morale to difficulty in recruiting physicians.

According to the report, physicians are stressed by internal and external factors, including healthcare reform, the economy, Medicare and Medicaid policies, uninsured patients, long work hours, and malpractice fears.

The most discouraging finding, however, was that only 15 percent of those surveyed say their organizations help them deal more effectively with their stress or burnout. Of course, that's probably because administrators also are stressed and primarily focused on keeping or getting the practice's finances in the black.

But while "physician health" may seem like a soft or low-priority issue, it does very much affect the bottom line. Physician stress not only creates malpractice risk and compromises staff morale and productivity, but it also drives physician turnover. And as we reported this week, every position a practice has to fill could cost nearly $3,000 during a three-month-plus vacancy. And the more unhappy doctors you have, the harder it will be to attract good ones to replace the ones who move on.

Nevertheless, I did promise some good news. And that's where practice leaders come in, according to Dr. Alan Rosenstein, medical director of PWS. "While administrators can't control external stress factors such as reimbursement and government policies, there is tremendous opportunity for them to better understand and recognize that physicians are stressed and provide them with services and support so they can have more energy, achieve better work/life balance, and be more resilient in order to effectively manage their stress," he said in a press release.

Though the study paints a dreary picture, its silver lining comes in the form of positive action points for administrators, which include but are not limited to the following:

  • Consider offering physicians flexible or reduced work hours. Although making changes to traditional practice is easier said than done, best practices are emerging for healthcare organizations to provide physicians with more manageable lifestyles. According to the PWS/Cejka study, nearly one-third of respondents indicated that better work hours/less on-call time and better work-life balance would help to reduce their stress.
  • Pay attention to office culture. As pointed out by Shelley Tudor regarding the Association of Staff Physician Recruiters benchmarking report, "Corporate culture drives physician decision much more so than compensation does."
  • Address conflict promptly. Related to practice culture are the issues of office conflicts and politics. Although many managers may be loathe to get involved with what may seem like petty tensions, Paula Comm, administrator at PRA Behavioral LLC, a three-site psychiatric practice near Chicago, recently told FiercePracticeManagement that she's got strict orders from her head physician not to let even the most minor issue fester. When any miscommunications or problems bubble up within the office, Comm is determined to deal with them immediately. "And it's healthier because I process it. We try to problem solve it. There's no blaming. We just try to figure out what's the misunderstanding and how do we fix this in the future," Comm said.

These are but a few ideas to help physicians better do their work. The strategies you employ at your practice might be different from what motivates doctors down the street; the important thing is that practices make the effort. What are you doing to promote physician wellness at your practice? What works? I look forward to hearing your ideas. - Deb (@PracticeMgt)