When I first learned about the tool of Appreciative Inquiry, I was not a fan. Although I've been a writer for almost two decades, I was trained in the scientific method in medical school. I tend to be skeptical of ideas with effects that are not easily quantifiable. I was doing some background research before interviewing two experts in the field, Richard Frankel, PhD, and Gene Beyt, MD, MS, for the AMA Steps Forward program, a series of modules to support greater efficiency and joy in practice.
The definitions I read, published in peer-reviewed journal no less, sounded extremely ethereal and free-form to me. Take this definition for example, "The essence of Appreciative Inquiry, then, is the study of what 'gives life' to organizations, teams, and people when they are at their best." (May 2011) I thought, how is something so amorphous as "giving life" going to solve the problems we see in health care today?
I spoke many times with Drs. Frankel and Beyt as I worked on the AMA module. I interviewed their colleagues. I reviewed the background studies on the effectiveness of Appreciative Inquiry. And I became a fan. Why? What swayed my thinking?
It took me almost two decades to look back and try to understand the reasons I left medicine. Leaving was an incredibly painful decision and the residual shame I carried made me want to look the other way—until I learned about burnout. Before, I thought it was me, that I was the problem. It was freeing to learn the truth: burnout is a psychological response to stress that has defined symptoms: emotional exhaustion, depersonalization, and inefficacy. Its triggers are well-understood, including those that affect physicians.
In 2013 I finally mustered the courage to write about my personal experience with burnout and leaving practice. I was shocked when the article went viral. Clearly my story struck a nerve. Since then I have made it my mission to learn all I can about physician burnout—its underlying causes, its consequences, and potential fixes.
In the course of my work I’ve interviewed dozens of physicians, researchers, health care leaders, and experts in burnout. I’ve learned that it’s a big problem for many physicians (actually it’s a big problem for many other health care providers, but what I know best is its effects on physicians). I’ve learned that understanding the root causes of physician burnout requires that you untangle the underlying flaws in our health care system. I’ve learned that burnout is not about the “weakness” or sensitivity of individuals and it can’t be prevented through individual wellness solutions alone.