The Hamster Wheel – Shorthand for Physician Burnout

Category Archives: Physician Burnout

The Hamster Wheel – Shorthand for Physician Burnout

As I delve deeper into the world of healthcare worker burnout, there is one image that appears too commonly.  Physicians say they feel like they are a hamster running on a wheel, or express a desire to “get off the hamster wheel.”

It seems that everyone can relate.  I’ve opened conferences on improving practice workflow with a video of a hamster running on a wheel, going so fast he ends up trapped spinning around while the wheel keeps going, and eventually falls off.  The audience members have a good laugh.  Later, many will tell me privately how strongly that visual resonates for them.

Hamster Wheel

How has this image become our shorthand for burnout?

I did some digging on Google, and found the following definitions:

From Wiktionaryhamster wheel (plural hamster wheels):

  1. circular cage for a hamster or other small rodent, which rotates vertically as the animal runs at the bottom.
  2. (figuratively,by extension) A monotonousrepetitiveunfulfilling activity, especially one in which no progress is achieved.

From the Urban Dictionarywhen someone just keeps running in circles (and making the same mistakes) in their life, instead of progressing

It’s depressing to think that highly trained medical professionals are describing their work lives this way.  I understood why when, on Wikipedia, I found this picture with the following caption:

Hamster Wheel 20150311

“Like other rodentshamsters are highly motivated to run in wheels.”

As caregivers, do we accept a workplace with unrealistic external demands and broken workflow processes because we are “highly motivated” to care for our patients and don’t see an alternative?

We chose health care as a profession because we were “highly motivated” to make a difference, to do something significant for our fellow humans.  We paid the price of sacrificing our 20’s with long hours of training to ensure that we could be trusted with other people’s lives.

Has our acculturation through medical or nursing training worn us down so that we simply accept whatever obstacles are put in our way?  Too many of us experience burnout.  It takes its toll in many damaging ways.

Drivers of Burnout

According to Maslach and Leiter in The Truth About Burnout, the drivers of burnout are six key mismatches between the worker and the workplace.  Let’s see how our hamster running on the wheel is impacted by these:

  • Work Overload – with too much to do, he can never get off the wheel
  • Lack of Control – he can’t stop the darn thing, and runs till he falls off
  • Insufficient Reward – he gets no special recognition or additional resources for this effort
  • Breakdown of Community – if two or more hamsters are in the cage together, they often end up running over each other o n the wheel. You can find videos of these on YouTube
  • Absence of Fairness – do hamsters feel it is unfair to put in all that effort with nothing to show for it, or do they simply enjoy it?
  • Conflicting Values – Hamsters seem to value running on the wheel, physicians who are feel that productivity requirements are superseding quality care do experience a mismatch

It’s time to stop sacrificing ourselves. It’s time to create healthy clinical cultures that respect dedicated hard-working professionals.

Lean Done Right is an effective approach to creating that culture.  It is based on two key principles – Respect for People and Continuous Improvement.

Respect for people means creating a workplace where we don’t have “highly motivated” people endlessly following the same routine and making the same mistakes, only at a faster pace until we collapse. We provide the right opportunities for the physicians on the front lines to get help implementing their ideas to fix problems effectively.

Huddles give us a chance stop and reflect, to address problems, to experiment with new ideas, to recognize and to appreciate our colleagues.

Designing flow cells around pull, rather than pushing more work into an already stressed system, results in a much less chaotic workplace.  Flow cells and pull systems drive quality and continuous improvement.  And yes, this does work in busy and productive hospitals and clinics.

What do you think?

Will you join us in transforming healthcare with Lean Done Right and returning the joy to patient care that we aspired to when we began our careers?

Are you ready to get off the hamster wheel?

Conflicting Values – Physician Burnout Driver Number Six

Today’s Posting on Conflicting Values is the sixth and final in my series on the drivers of physician burnout as described in The Truth About Burnout by Maslach and Leiter.  Physicians place great value in their ability to provide compassionate quality care to their patients.  Health system leaders similarly proclaim a dedication to compassion and… Continue Reading

Absence of Fairness – Burnout Driver #5

Today marks the fifth entry in my weekly series reviewing the six key drivers of burnout described in Maslach and Leiter’s classic book The Truth about Burnout – Absence of Fairness.  They state “A workplace is perceived to be fair when three key elements are present: trust, openness, and respect.”  This makes intuitive sense.  When… Continue Reading

Fixing Frustrations at the Front Lines

Here is another in my series of vignettes about health care organizations that are reducing physician burnout, taken from our book Preventing Physician Burnout: Curing the Chaos and Returning Joy to Patient Care. Following my post on Sunday about burnout driver #3 – Insufficient Reward – I’m happy to share this example of Lean providing… Continue Reading

Physician Burnout Driver #3 – Insufficient Reward

Today’s posting takes a deep dive into the third driver of physician burnout – Insufficient Reward.  When most of us think about the reward we receive from work, we first think about compensation.  Most doctors are paid relatively well.  Pay is an extrinsic reward.  Many will argue that what they are paid is not worth… Continue Reading

Lack of Control

Today in my ongoing series on the six drivers of physician burnout we discuss burnout driver number two as identified by Maslach and Leiter in The Truth about Burnout – Lack of Control. In last Sunday’s post we discussed the first driver – Work Overload – which for physicians is exacerbated by a chaotic work environment… Continue Reading

Work Overload – First Driver of Burnout

Over the next six weeks I will be posting about each of the six primary drivers of burnout, starting today with the first of the six – Work Overload.  Work Overload is the first thing people think of as a root cause of burnout.  When there is too much to do, people become overwhelmed and… Continue Reading

A New Year with a Primer on Physician Burnout

Welcome to 2017! I’m taking a new approach this year, starting off with a series on all things Physician Burnout. I’ll start off with a weekly update on Sundays explaining each of the six drivers of physician burnout in successive posts. Midweek I will share vignettes about health care organizations are reducing the risk of… Continue Reading

Preventing Physician Burnout Now Available on Amazon

Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine, is now available on Amazon. You can order the paperback version here. In addition, the Kindle edition will be available in about two weeks. My co-author, Diane Shannon, and I spent over a year researching this work, interviewing over 50 experts… Continue Reading

IHI Forum – Pursuing the Quadruple Aim to Prevent Physician Burnout

As I write this, I am at 33,000 feet somewhere over the middle of the country on my way to the 28th Annual IHI Forum in Orlando.  I’m looking forward to many great opportunities to support the Quadruple Aim and Prevent Physician Burnout this week.  Stay tuned, as I will be sending updates on a… Continue Reading