Maximizing ROI and Work Life Balance

Category Archives: Burnout

Maximizing ROI and Work Life Balance

“Doctor, you need to see more patients.”  Too often these days physicians hear this from their CEO or CFO and think, “I can’t do any more without cracking.”  In a recent post directed to CFOs I discussed the financial impact of burnout on hospitals and health care systems. Physicians are cracking under the strain.  Today’s post is directed to both physicians and CFOs, because both can benefit from investing in redesigning care delivery, maximizing ROI (Return on Investment) in their areas of greatest concern.  For physicians, while salary is always important, more of us are reducing our patient loads in order to regain much-needed work life balance and stay sane.  For CFOs, as the impacts of whatever happens with health care reform increases uncertainty, improving productivity is a key to weathering the oncoming financial storms.

Maximizing ROI Requires Making an Investment

OK, this seems pretty basic, at least for MBAs who have invested their own time (and often their own money) getting educated in business, finance, and accounting.  They have made this investment with an expectation of a return consisting of a better job, or a better ability to perform their job.  Physicians have invested a decade of their lives with an expectation gaining the knowledge and experience needed for patients to trust them with their health.  So the concept of expecting a return on an investment is shared by CFOs and MDs.  If we made the investment, then maximizing ROI makes sense.

Can CFOs and Physicians Find Common Ground?

Primary care physicians generate $1.5M in revenue for the hospital they are affiliated with.  If they reduce their workload by 20% to maintain work life balance, they regain work life balance with the downside of reduced personal income.  For the hospital, this translates into a $300K reduction in revenues. It’s a no-brainer for CFOs to invest $50-100K if it returned $300K. That’s are ROI of at least 3:1.

Physicians are reluctant to invest their time in activities that could improve their efficiency and work life balance without reducing their patient load. When we ask physicians to participate in huddles for 15 minutes a day, or worse yet, to participate in a week-long Rapid Improvement Event, many will complain that it will take them away from their patients, reducing their income and hurting patient care.  They have good reason for concern, as prior initiatives coming from administration and promising to improve quality, service, or productivity have often made things worse for physicians.

Redesigning Around Team Care as Common Ground

The growing movement of team care provides the opportunity for common ground – for CFOs to invest in additional support staff for physicians, and for physicians to invest their time in redesigning their work to use the additional support staff effectively. Surrounding an office physician or a hospitalist with a team makes sense.

No surgeon would start an operation without a team there for support.  The surgeon can’t provide anesthesia, be handed the right instrument at the right time, and manage the rest of the patient’s needs while also focusing on the procedure effectively and performing it efficiently.  Yet as cognitive care has gotten more complex, we have been slow to add support staff who can do the same for physicians who could focus more effectively on their patient and provide care more efficiently, if their time was spent performing at the top of their license,if they weren’t clicking away at a keyboard entering data, and if messages were teed up for them effectively.

Here are a few options to learn about team care, there are a number of others that are easily found on a Google search.

Will You Make the Investment?

The key is your willingness to change.  Will you, as a CFO or as a physician, be willing to invest dollars and your time to improve your financial and personal bottom lines.  Can you see that pursuing a common investment can achieve success on seemingly differing goals?  If not, I’d ask you, “Why not?”  What we are doing now is not working.

Have you had experience with team care?  If so, what worked and what didn’t?  Please share by clicking here to enter a comment.

Tight-Loose-Tight Leadership and A3 Thinking

Are you a “results-oriented” leader?  I hope you are, because you need good results to be successful.  How do the people you lead feel about your focus on results? Are they empowered or feeling burned out? The “Tight-Loose-Tight” approach to leadership can ensure results while empowering your team. The basic concept of “Tight-Loose-Tight” is for a leader to… Continue Reading

Servant Leadership

How do you approach Servant Leadership?  Do you aspire to serve those you lead?    I’ve struggled a bit with what the concept of servant leadership truly implies. A servant’s master can command the servant to perform tasks that primarily further the master’s self interest.  If, as servant leaders, we must obey the physicians and staff no… Continue Reading

The EHR – A Root Cause of Physician Burnout

The most important thing that we do in health care is the healing interaction that takes place between a caregiver and a patient. The opportunity to participate in that sacred relationship, and to be of service to others, is why most every doctor went into medicine. The EHR, as we currently use it, is breaking that relationship and damaging our ability to heal. Continue Reading

Reducing Physician Burnout without Reducing the Bottom Line

How can you reduce physician burnout in your workplace without hurting the bottom line? When most people think about burnout they think about its primary manifestation – exhaustion.  Burnout also manifests as cynicism, which damaging to the person and those around him/her, and as inefficacy, the sense that what you do doesn’t make a difference.… Continue Reading

Diagnosing Burnout – Not as Easy as You Might Think

How would you diagnose a physician experiencing burnout?  The classic definition includes a combination of emotional exhaustion, depersonalization (often manifesting as cynicism), and a sense of inefficacy (reduced personal accomplishment).  If he/she presented to you as a patient, and as a result of your workup your treatment recommendation included reduced work hours to time off from work,… Continue Reading

I recently was asked to work with a health system that is struggling with physician engagement in their Lean program. Nothing new about that. Doctors are so busy trying to take care of higher volumes of increasingly complex patients that they can’t afford the time to fix the dysfunctional workflows that stand in the way… Continue Reading

“… if you take it away, it’s all people can think about. The instant people perceive disrespect in a conversation, the interaction in no longer about the original purpose – it is now about defending dignity.” (Crucial Conversations, by Patterson, Grenny, McMillan and Switzler). Dr. Monica Broome, MD, shared this quote today in a presentation… Continue Reading

In their recent Perspective piece in the New England Journal of Medicine entitled “Medical Taylorism”, Drs. Pamela Hartzband and Jerome Groopman make a fundamental attribution error. They equate Lean as practiced according to the principles of the Toyota Production System that empowers workers to solve problems, with the approach used by Frederick Taylor over 100… Continue Reading

Did you see this recent post on MedPage Today? “Burnout: Is Medical School the Staging Area? Burnout prevention starts in medical school” If not, you can find it here. The article describes important new work at the University of Chicago Pritzker School Of Medicine to improve medical student resilience. It’s great to see medical schools… Continue Reading