Earlier this week, I was asked an intriguing question by an interviewer: “If you had a magic wand and could have one wish for improving the well-being of clinicians and addressing burnout, what would it be?”
My response? Respect. Respect for the humanity of everyone who touches the health care system—patients, family members, administrative staff, organizational leaders, clinical staff, clinicians, cleaning staff, parking valets, pharmacists, lab technicians, front desk staff, and the folks who answer the phone and help with appointment scheduling.
My answer was not really a fair one. I believe that respect of this sort triggers a wide array of improvements and is only possible on an organizational level when all sorts of other support structures are in place and working well. So it was cheating on my part to choose one wish that encompasses many.
If we truly respect the humanity of everyone in health care, how would this change our approach to clinician well-being?
Many leaders of health care organizations are navigating tricky waters these days. Most now recognize that clinician burnout is a problem but are unsure what to do about it. Some avoid surveying clinicians because they don’t want to unearth problems that seem impossible to fix. Others schedule a resiliency retreat or mindfulness training. Individual solutions like these are a great start but if leaders go no further in addressing the systemic problems, they may face backlash from physicians who are angry at the implication that the problems they face are of their own doing.
Given how difficult it can be for organizations that have acknowledged burnout among their clinicians to determine how to address it, I was intrigued to hear how one physician leader, Chief Physician Experience Officer and Executive Medical Director for Patient Experience at UCSF Medical Center, Diane Sliwka, MD, has steered this largely uncharted path.
Did leaders adapt best practices from other academic health systems and institute them at UCSF? Did they pick a handful of specific interventions to try? Did they offer the standard individual-based solutions? Did they attempt to identify and address the systemic causes of burnout? And, of course I wanted to know what kind of results they’ve seen.
On a sunny day in July, I dutifully ensconced myself at my desk and connected to a half-day National Academy of Medicine conference on burnout. All the speakers were interesting, but my ears really perked up toward the end of the event, when Jo Shapiro, MD, director of the Center for Professionalism and Peer Support and Chief of the Division of Otolaryngology in the Department of Surgery at the Brigham and Women’s Hospital in Boston and an Associate Professor of Otolaryngology at Harvard Medical School, spoke about the connection between leadership and physician well-being.
Her comments resonated with questions I’ve been contemplated a lot lately: What role do leaders have in addressing burnout among their physicians? And how do we compel them to do so, when they have so many conflicting priorities? Too often, leaders don’t seem to grasp the importance and severity of burnout, especially among their physicians. Most of the physicians with burnout whom I’ve interviewed describe little if any effective action from leaders to address the underlying causes of burnout.
I contacted Shapiro, who generously agreed to a phone interview. Here’s a recap of our conversation.