Can health care leaders afford to take actions preventing burnout in physicians? Perhaps the better question to ask is, can they afford not to? In a recent letter published in the Mayo Clinic Proceedings, Shanafelt et.al. describe the potential impact of a reduction in physician work effort and in the physician workforce due to increasing physician burnout.
They calculate that for a one point increase in emotional exhaustion on the Maslach Burnout Inventory, there is a 43% likelihood of reduction of professional effort over the next 24 months.
Put in more practical terms, the increase in professional burnout noted in their study published in December of 2015, from 45% to 54%, likely resulted in a 1% reduction in national physician work effort. If that doesn’t sound too bad, they also point out that this is the equivalent of losing the graduating classes of 7 average-size medical schools each year.
(It’s likely higher, because they don’t account for physicians who take early retirement as a means to cope with burnout.)
Are Efforts at Preventing Burnout Worth the Cost?
Let’s consider a few salient facts.
- As the letter states, physician work effort reduction is an effective personal approach to reducing burnout.
- Despite the conservative projections in the letter, most physicians know of many colleagues who have reduced from full time to part time work in order to cope with growing work life imbalance.
- Most hospitals run on razor thin operating margins.
- A reduction of revenues of 1% could force a hospital to make difficult financial decisions. Greater amounts can cause worse trouble. We’ve all seen such actions over the last few years.
So well designed efforts for preventing burnout can have a strong return on the investment, and many options don’t cost much.
Where Should Leaders Start?
- Build strong relationships with physicians.
- Meet with them to ask what they think.
- Spend a day shadowing them to see firsthand the barriers and frustrations encounter. This shows respect and builds rapport.
- Survey the medical staff, using research validated approaches, to learn more about the specifics of burnout in your organization.
- Use the Maslach Burnout Inventory to identify which specialties are most impacted.
- Use the Areas of Worklife Survey to learn which of the drivers of burnout are most significant.
- You can find both here.
- Share the results with your medical staff and develop an action plan together.
Once you’ve started, keep at it. Cynicism is a major manifestation of burnout. Physicians who are burned out and experiencing exhaustion and cynicism will need you to reach out to them more than once before they engage. It’s taken many years for things to get this bad, and it will take time to turn it around. If you stick with it, and your efforts are sincere, you will see the difference – improved relationships with the medical staff, reduced levels of burnout, and an improving bottom line.
This approach will return joy to patient care for physicians, and ideally return joy to health system management for the leaders.
What do you think? Are doctors reducing their work hours to cope with burnout? Is there a better way for everyone?