​When I was in residency training, I felt struggled with a conflict between my perception of reality and a seemingly widespread fallacy. As a human being, and especially as a human new at the tasks I was undertaking, I knew I was imperfect, yet the clinical world seemed founded on the belief that it is possible for humans to never make mistakes. Only perfection was acceptable. The possibility of unintentional medical errors was usually just denied. If errors occurred, they were seen as the individual health professional’s fault. In other words, if a mistake happened, I’m to blame, even if I was doing my best in a broken system, one that required multiple error-prone workarounds to complete a task. That conflict ate away at me, and was one of the factors that precipitated burnout and my decision to leave clinical practice several years later. 
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It was in the course of writing about the health care system that I first learned about organizational culture, which can be loosely defined as “how we do things around here.” It governs how people act, how they respond, how they treat each other. It is shaped by top leaders. They set the tone, model ways of being, and choose which behaviors to reinforce and reward, which to call out, and which to overlook (a choice that usually speaks louder than words). Leaders’ actions and choices demonstrate the organization’s culture for everyone else. Of course, there are micro unit cultures that differ across the organization, but the trickle-down effects of leaders show up here too. 

I recently wrote a guest post on the changing demographics of American physicians. I crafted it as an open letter to organizational leaders, who need to understand and respond to the shifting needs of these physicians if we are to have a healthy physician workforce in the years to come.


Dear Healthcare Leaders, Board Members, and Interested Others:

You may have noticed a recent trend in your human capital. If you haven't, here's the upshot: Your physician workforce is changing.

And to guide your organization, you'll need to understand those changes — and shift your priorities accordingly. As a physician and author dedicated to helping my clinician colleagues thrive, I'm here to help.

Here's how your workforce is evolving...

Read the rest of the post here!

When I speak to groups or write about physician burnout, I often hear back from clinicians who are thankful someone is validating their experiences. As one young physician wrote me:

“I went into medicine for the right reasons, but find myself, after only six years, approaching burnout. I felt like I would be a failure if I were to ever actually say [this] out loud … I feel frustrated by the lack of support from the administration."

Her email reflects the sentiment of too many physicians today who feel their organizational leaders simply do not care about the inefficiencies and systemic issues that are a major cause of the widespread burnout among clinicians.

Indeed, a new athenahealth survey of more than 1,000 practicing physicians found that physicians who gave low marks to the long-term leadership abilities of their administrators were more likely to report low confidence in their ability to do their job well and more likely to exhibit low levels of engagement — as defined by their willingness to go above and beyond in their jobs and to recommend and stay with their organizations.

Read more here.