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.
I recently wrote a piece for athena insight, based on a focused review of athenahealth's data on physician gender and burnout. What I saw intrigued me, and led me to think we need a better way to measure and reward the work that physicians do...
Is the practice of medicine a different experience for male and female physicians? Two recent studies from athenahealth suggest that it is — in ways that should make us rethink what we value in health care.The first study found that male physicians are more productive than their female counterparts. In an analysis of 47 million visits on the athenahealth network in 2016, male physicians generated 30 to 40 percent more work RVUs than female physicians. (A work RVU, or relative value unit, is a measure of physician work effort that is used to calculate reimbursement.)
The second study found that professional burnout is higher among women physicians. A survey of 1,029 practicing physicians found that women under 45, in particular, were significantly more likely to report burnout than men.
In other words, women physicians are both less productive and more likely to burn out.
Read more here.