If healthcare organizations aren’t taking steps to tackle physician burnout, they should be, said Marjorie Bessel, M.D.
“Every single healthcare system should be more focused on this issue,” said Bessel, the chief clinical officer at Arizona-based Banner Health, where she has been at the forefront of addressing the problem of physician burnout and ways to prevent it from negatively impacting her health system.
“This is one of my absolute top priorities,” she said.
Some of the results of physician burnout are very profound for healthcare organizations, Bessel said in an interview with FierceHealthcare.
Doctors who are burned out are more likely to leave the practice of medicine or to decide to retire earlier, at a time when there is already a shortage of providers, she said. They are also more likely to commit a medical error, and their fatigue may affect patients’ healthcare experience. At the end of the spectrum, burned out physicians are also more likely to commit suicide, which with one physician suicide in the U.S. every day—the highest rate of any profession—is a serious repercussion.
A new paper published today said burnout has become so pervasive that it is a “public health crisis.” The report by the Harvard T.H. Chan School of Public Health, the Harvard Global Health Institute, the Massachusetts Medical Society and Massachusetts Health and Hospital Association included some dramatic directives including that every major healthcare organization should appoint an executive-level chief wellness officer, provide proactive mental health treatment and support for caregivers experiencing burnout and improve the efficiency of electronic health records.
“It’s incredibly important to do something and to do it from a holistic approach,” said Bessel, who has been with Banner for almost 13 years has been in the role of chief clinical officer since February.
That is the way that Banner Health, one of the largest nonprofit healthcare organizations in the country, has approached the problem. While healthcare organizations can take a scattered approach, they will have the most success with a comprehensive program, Bessel said.
Banner Health has centered its program around six validated and evidence-based actions, touted by Stephen Swenson, M.D., an expert on the issue who has studied physician burnout and ways to reduce it in his roles at both at the Mayo Clinic and at Intermountain Healthcare, said Bessel.
Those actions to cut burnout, which is estimated to affect more than half of all doctors, center around the following:
Focus on resilience. Banner is taking steps to bolster the wellness of doctors. For instance, it encourages gatherings of physicians to talk about the importance of work-life balance and factors such as best diets, use of meditation and proper sleep that can help protect individuals against burnout.
Build commensality. The physician lounge at the hospital was once a place for doctors to get together and build camaraderie. No longer is the hospital at the center of many doctors’ days, said Bessel. Social gatherings of physicians and practices have fallen to the wayside. So, Banner has funded opportunities for doctors to come together, such as going out for breakfast or lunch. That can rebuild relationships between physicians.
Design organizational systems to address human needs of practitioners. At Banner, it’s become important to measure the satisfaction levels of doctors and other employees. The healthcare system conducts employee engagement surveys and tracks burnout rates, Bessel said.
Reduce harm and support second victims. Adverse events happen in healthcare. It’s not only a patient and family who suffer. Those who are caring for the individual are very much affected, Bessel said. When mistakes happen, it’s important healthcare organizations provide support to staff and take care of so-called second victims.
Make sure your leaders have participative management competency. Your leaders must work collaboratively with the other people on their teams, Bessel said. Leaders must have that level of competency to ensure that they listen to staff members and appreciate their work.
Remove sources of frustration and inefficiency. Swenson calls them the “pebbles” that are in someone’s shoes. They are the irritants that make a job difficult. For physicians, one of the biggest is the electronic medical record (EMR), and organizations must focus on trying to make it easier to use, Bessel said. Organizations need to address any of those pebbles that give people their greatest frustration and get in the way of delivering care. Banner has looked at the workflow and tried to streamline processes and reduce tasks. For instance, Banner spends a lot of time measuring who is in the EMR longer than colleagues and what interventions might cut down on that time drain. It has trained individual trainers who can work with physicians and pinpoint ways to help with documentation, chart review and placing orders.
In a large organization such as Banner Health, it’s been important to have high-level support for her work trying to reduce physician burnout, Bessel said. For instance, she’s been before Banner’s board of directors twice in the last year talking about the burnout problem and what actions the system has taken.
With more than 30 hospitals and specialized facilities across seven states and more than 50,000 employees, it’s been a balance of homegrown efforts at the local level and system-level efforts to combat the problem, she said.
It’s important healthcare organizations thank physicians and acknowledge that their work does take a toll on them, she said. On National Doctor’s Day in March, for instance, she sends a message to every Banner physician expressing appreciation for the work they do. “They do so much for the people they care for,” she says.
Banner also established a two-year advanced leadership program designed to identify and develop physicians to become Banner leaders.
Banner has about 2,000 employed physicians and advanced practitioners and another 8,000 physicians are affiliated with its system. The healthcare system reaches out to both groups to address physician burnout.
It’s not just large healthcare systems that need to target physician burnout, she said. The actions Banner takes to address physician burnout can be duplicated on a smaller scale in physician practices. It is a way to help people at the bedside taking care of patients be their best, she said.
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