I am VERY resistant to burnout solutions that focus solely on the individual, as these seem to imply that the problem originates in the affected person. This approach pokes at a sore spot, because of the years I spent secretly worried that the reason I left practice was personal weakness or inadequacy, something I lacked or failed to do.
When in 2013, I ran across the research on burnout, I learned otherwise. By definition, professional burnout is caused by workplace stress. It is not due to a personal weakness, and it can happen to anyone.
My presentations and the book I co-authored make this point—that while individual-based solutions like mindfulness and medication practice are very valuable, they must not distract a health care organization from dealing with the underlying causes of stress in the workplace: broken processes, disrespectful culture, inefficient electronic health records (EHRs), lack of team-based care.
A recent interview caused me to rejigger my thinking on the topic. Tom Jenike, MD, is chief human experience officer at Novant Health, an integrated health system in North Carolina. (Love the title.) He began our interview describing an initiative at his organization that focuses on building resiliency in clinicians. A dime a dozen, I thought. Yet another health system placating frontline physicians and nurses with stress reduction techniques.
But within the span of the call, I changed my mind about the relationship between individual and systems solutions. Why? Because of the results—not just the engagement and satisfaction outcomes, but the culture and systems changes that the initiative has catalyzed.
At the Wingspread Summit in November, I met many colleagues engaged in addressing physician burnout. From Corey Martin, MD, I learned about a really innovative program in Minneapolis—although initially I struggled to see the connection between the initiative and physician wellbeing.
The Bounce Back project builds on the evidence that happiness improves health outcomes and on the idea that specific practices (“tools”) can build resilience to stress—enabling people to “bounce back when life doesn’t go as planned.”
On the phone recently, I asked Martin why he became involved in Bounce Back. He explained that three painful events led him to help found the Bounce Back project.
In 2014 a young, well-loved physician at Martin’s hospital died in a vehicular crash, leaving a spouse and four children. As the hospital staff struggled to recover from his death, a respected pediatrician took his own life in the hospital chapel. His death profoundly shook the hospital staff and the local community.
The morning after his death, a unit clerk confided to Martin that when she heard the news, she thought it was Martin who had died by suicide. He told me, “If other people could see the burnout in me and I could see it in my colleagues, I knew we had a serious problem.”
Soon thereafter, a 15-member group consisting of medical staff and senior administrators of the hospital attended a conference on resiliency convened by the Minnesota Hospital Association. Bryan Sexton, PhD, director of the Duke Patient Safety Center at Duke University Health System, presented several tools that have been shown in research studies to increase resiliency. According to Martin, these evidence-based tools form the basis of the Bounce Back project.