Redesigning Clinical Workflows to Return Joy to Patient Care
Physician Burnout Driver #3 – Insufficient Reward
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 it for the effort and hassles they put up with.  Every day physicians confront barriers and frustrations to providing quality care that lead to burnout.

That’s why insufficient reward is directly connected to the second driver of burnout – Lack of Control. Doctors are mission-driven professionals.  They have sacrificed a lot to earn the trust of their patients.  Because we have earned their trust, patients tell us things they tell no one else.  They let us do things to them that no one else in society can do legally. Our patients’ trust in an intrinsic reward.  Yet it is all too common these days for physicians to be treated by leaders, and by some patients, as though we are not worthy of trust or respect.

Respect is Like Air

Intrinsic rewards are deeply tied to respect. “Respect is like air.  If you take it away, it’s all people can think about.”  Dr. Monica Broome is an international expert in the neuroscience of communication. She shares this quote from Crucial Conversations in her presentations, making the point that lack of respect in healthcare drives the epidemic of physician burnout.

Lack of Respect Drives Insufficient Reward

42257703 - doctor in surgery examining young girl

Physicians thrive on the respect embedded in intrinsic rewards.  These include:

  • The trust our patients give us
  • The professional status we have earned through decades of hard work, and
  • The joy we experience when patient care flows smoothly.

Having already discussed patient trust, let’s look at professional status and joy in patient care.  Professional status for physicians had deteriorated significantly over the last few decades.  There are a variety of reasons for this as societal norms and the way medicine is practiced have both changed significantly.  Whatever the reasons, we feel that loss of status as insufficient reward.

Perhaps the most compelling intrinsic reward is experiencing joy in caring for patients. We experience the joy of patient care, like athletes in peak performance, when we are in “the zone.”  This is a time when everything comes together.  We move effortlessly through the day able to use our professional knowledge and skills in a setting that facilitates our best work, in sync with our colleagues and support staff, and connecting fully with our patients.  Those days, or moments, when we are in “the zone”, are fewer and farther between.  Our workplaces are full of barriers and frustrations that limit our effectiveness.  We burn out when we can’t work effectively.

Removing Barriers and Frustrations

Lean offers us a chance to deal directly with insufficient reward. When Lean is done right, based deeply in the Lean principle of Respect for People, physicians are empowered to fix what’s wrong in our workplaces.  We know what the barriers that cause our frustrations.  We have good ideas that can remove many of those barriers.  Given the chance to partner with our clinical colleagues and enlightened leaders, we can fix a lot.  That takes trust from leadership.  That trust exemplifies respect.

huddle-boardAn Insufficient Reward Action Plan

So how do we reduce insufficient reward?

If you are a leader, listen to your physicians.  Listen deeply with respect.  Engage with them in process improvement activities.

If you are a physician, find a member of your organization’s leadership that you can trust.  Reach out to them with respect for their challenges.  Offer to partner with them on process improvement.

The Lean approach of a week-long Rapid Improvement Event is a great way put these recommendations into action.  RIE teammates learn from and about each other.  They realize that working together they find solutions that remove barriers and frustrations to quality care.  They come away both empowered and with deep respect for each other.

Have you found an effective way to reduce insufficient reward?  Does it follow the action plan above?  Or do you have another approach that we could all learn about?

Please share your thoughts by clicking on the “Comments” link above.

And check back here on Wednesday, when I’ll share a vignette from our book on how the University of Michigan has engaged their teams to improve the workplace and reduce insufficient reward.

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