Legend has it that a frog will jump out if placed into hot water, but if you raise the temperature gradually it will stay until it’s cooked. This is an apt analogy for how older physicians currently view their jobs. If we were to jump from college graduation into our current high-stress, low-control jobs, many of us would jump right out. Yet, our current jobs have evolved gradually over the last 20 to 30 years, and we manage to stay in them. The key to not getting cooked is to prevent and treat burnout as it arises.
I recently came across a useful way of organizing my thoughts on my personal struggle against burnout. I found it on Dike Drummond’s website (TheHappyMD.com). He calls it “The Burnout Prevention Matrix,” and it’s readily available in exchange for opting in with your email address.
I had been searching for some time for a framework that doesn’t put the entire onus for health on physicians and nurses. Dike’s matrix includes responsibility for organizations to reduce stress and energy drains on their employees, to increase recharge activities and efficiency for their employees.
Organizations will hone in on the word “efficiency” here, I’m guessing, because increased efficiency can lead to higher revenues, but what about the need for employees to have time to recharge?
Can organizations support a culture in which it’s considered normal to have work/life balance? Although I disagree with Paul Ryan on most things, I was really happy that he publicly placed a high priority on spending time with his family. It sent a strong message to all of us who struggle to find that time. I named my previous private practice “Life Balance Health Care,” but now I feel that the name was ironic as I look back on how much time I spent working in that practice.
In that time, though, I was able to forge some useful tools personally. (Sign up for my newsletter with your first name and email to get a free pdf of My Personal Anti-Burnout Toolkit.) I tried to influence the organizational culture, as well, during my time as Medical Staff President. I prided myself on running meetings in which, if consensus couldn’t be reached, at least disagreements were verbalized respectfully so that both sides felt heard, and they understood each other’s viewpoint. It was just a small pebble to throw into the frog pond of hospital culture. Hopefully my pebble made some ripples before it began to sink to the bottom.
Much more can still be done to support health-care providers to feel more empowered, less disenchanted. For instance,
- Near miss/bad outcome outreach and education
- A confidential 24/7 physician counseling hotline
- Fair reimbursement for physician leadership activities
- Training in Motivational Interviewing to help patients make lifestyle changes
- Training in empathetic communication with patients and coworkers
- A Physician Wellness Committee – with
- Authority to take formal and informal surveys of staff needs
- And a Budget
While it’s possible for physicians to run self-led support groups, like Balint groups, or Rachel Remen’s “Finding Meaning in Medicine” groups, these can’t have the impact of having administrative and financial support from the overall organization in changing to a culture of caring for staff.
We’ve all read the statistics on burnout, how pervasive it is, how damaging to both providers and patient care. It’s incumbent on all of us, individuals and organizations alike to begin to do something about it.
Which of these suggestions do you think would be the most helpful to you? What would you be willing to do to help bring it about? Leave a comment below. Let’s start working on this together.