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.
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.