How Novant Health tackled physician burnout

Tackling physician burnout didn’t come cheap for Novant Health.

The North Carolina-based health system has invested more than $2 million to develop, implement and promote a resiliency program to help physicians, as well as nurses and administrative leaders, whose demanding jobs have taken a toll on them.

But that money has paid for more than 800 physicians, or about half of Novant’s employed doctors, to participate in the voluntary program that focuses on their wellness, write Carl S. Armato, Novant’s president and CEO, and Tom E. Jenike, M.D., senior vice president and chief human experience officer, in NEJM Catalyst.

It's been worth it, Armato said.

“I’ve regained my love of seeing patients,” said one doctor who participated in the program.

Data backs up the return on investment. Those who participate in the program score higher—sometimes more than 50% higher—on key measures that include personal fulfillment, alignment with Novant’s mission and positive attitudes toward the organization, according to Armato and Jenike. Novant Health’s medical group now ranks in the 90th percentile nationally in physician engagement.

Currently, there is a waiting list of providers who want to participate in the program. They give up a weekend or a full day to attend either a 3-day wellness retreat or a condensed one-day version of the program at an off-site location. The program is designed to help physicians achieve better work-life balance, develop their leadership skills, boost their engagement, resiliency and wellness and find more fulfillment in their professional and personal lives, say Armato and Jenike. The initiative includes a one-on-one coaching and mentoring program and single-session conversations.

Burnout has gotten so bad that research last year showed that it has led 1 in 5 doctors to plan to reduce their clinical hours. And roughly 1 in 50 plans to leave medicine altogether within the next two years.

The two healthcare leaders offer three tips for organization leaders who want to develop a physician resiliency and wellness program:

• Decide who will “own” the program. You need someone to take charge. At Novant, Jenike facilitates the program with support from leadership within its medical group.
• Decide your budget for a program. Novant budgets approximately $3,500 for each physician participant. The cost is less for other providers, such as nurses, at approximately $400 per participant. The health system is also accredited to offer continuing education credits for physicians and nurses.

• Decide what metrics you will use to access the financial and nonfinancial benefits of the program. Novant has seen an impact on recruitment and retention, including a 300% growth in its employed medical group since it began the resiliency program. Replacing a physician can cost two to three times the annual salary of a physician who leaves an organization.

Burnout isn't just a serious problem for providers, it’s an expensive one for health systems, costing up to $1.7 billion a year in turnover among hospital-employed physicians. The costs for burnout-related turnover may be as high $17 billion for all U.S. doctors, estimates from the National Taskforce on Humanity in Healthcare show. The task force also estimated that burnout among nurses costs hospitals an additional $9 billion annually and $14 billion to the healthcare industry at large.