Issue link: https://beckershealthcare.uberflip.com/i/593112
65 PRACTICE MANAGEMENT THOUGHT LEADERSHIP ways I have become the kind of doctor I never thought I'd be: impatient, occasionally indifferent, at times dismissive or pater- nalistic," Sandeep Jauhar, MD, wrote for the Wall Street Journal. e 2014 column was titled "Why Doctors are Sick of eir Pro- fession." "I am emotionally exhausted and suffering from burnout. I realize how scared and vulnerable my patients must be feeling. Unfortunately, I am unable to spend the time I'd like with each patient because I have so many other patients whose needs must also be met," a four-year medical student said in a 2013 column for the New York Times. "For a two-year period, I would use the weekend to gear up for the week, then be depleted by the end of the week. I felt like a grape on Mondays, and by Fridays my vitality was drained and I felt like a raisin," George Ford, MD, wrote in Healing Physician Burnout. What is triggering the burnout epidemic? "Today, physicians are expected to have much more knowl- edge of teamwork than ever before. An organization suddenly decides to implement Lean, and physicians need to be experts on patient flow. ey need to have technology skills for the new EMR. ey're asked to use problem-solving skills in ways they never have before," Mr. Studer writes. Burnout is one result of many complex changes unfolding in healthcare. In his book, Mr. Studer outlines a few overarching trends contributing to the chronic fatigue many physicians expe- rience, including: • e shiing payment model from fee-for-service to pay-for-performance • e imminent physician shortage • An aging population in need of more care • Changing patient expectations • Increased transparency • Changing technology ese forces are coupled with physicians' direct experience, which oen involves a shortage of sleep and long hours — 40 percent of physicians reported working more than 60 hours per week in 2014. Physicians also feel they spend too little time with patients — A Geneia survey of more than 400 full-time physi- cians found 78 percent felt rushed during their time with patients — and too much time on administrative tasks. e explosion of technology and EMRs has exacerbated their time constraints. "While many physicians agree that EMR will be a good thing in the long run, getting accustomed to them is far from easy," Mr. Studer wrote. What can executives do about it? ere is no one factor to blame for physician burnout, in- sists Mr. Studer. e fact is, when a person's external environ- ment changes so drastically, he or she cannot avoid feeling over- whelmed and stressed out. e good news: ere's a lot healthcare executives can do to help physicians cope. For example, they can help by recognizing that physicians are their industry's top performers and by doing everything possible to provide feedback and support — in the same way that other fields such as athletics, the arts and military do. "Every other elite profession gives a lot of feedback to their highest performers," says Mr. Studer. "Top athletes watch videos of the games to learn from mistakes, for example, and ensuring that they get enough sleep, nutritious meals and exercise are top priorities. ere is no reason why we can't do the same in health- care." Mr. Studer remembers the young physician who operated on his sister in 2014, Pamela Hodul, MD. e procedure took 13.5 hours and ultimately was not successful, as Mr. Studer's sister died shortly aer. When Dr. Hodul emerged from the OR, she was emotionally and physically exhausted. She later broke down and cried, another physician told Mr. Studer. Mr. Studer pointed out that this ordeal was treated as just an- other day of this young physician's six-day workweek. "What type of nutrition do you think she'll get?" he writes. "What type of conditioning training has she had to prepare her to handle this type of situation? What type of rub-down will she get from a trainer? Most likely what she'll get is a hard bagel and a cold cup of coffee before she goes home so she can grab a few hours of sleep before she has to do rounds the next day." Not only is the physician's job incredibly physically demand- ing, it oen puts them through an emotional wringer. When a pa- tient dies, many physicians internalize their grief or feel as though they have failed. Opportunities for collegiality and honest, safe peer-to-peer dialogue can be few and far between. Mr. Studer urges hospitals and health systems to invest in wellness programs, support groups and feedback systems for physicians, and to think of these resources not as expenses but as investments that will pay off — many times over. He also recom- mends CEOs, CMOs and other high-level executives make time for feedback. "It would be really exciting if time was taken with physicians on a regular basis to create a professional development plan to track their progress and performance — much like other indus- tries do for their top performers," he writes. Expense is obviously an issue, but Mr. Studer broke down some numbers. If a physician makes $200,000 a year with ben- efits, that totals $1 million over a five-year period. How does the hospital treat pieces of equipment that cost $1 million? "A ma- chine would not just be bought and installed only to have the organization just move on," he writes. "Instead, it would receive regular check-ups and enforcement to ensure it was operating at an optimal level. "Organizations that offer these types of services are going to win," he writes. "Even physicians who don't take advantage of sup- port groups are going to feel good about those that are offered." n