We wrote recently about the backlash in the medical community against the concept of “burnout.” My thought is the word is not the problem. The approach that health systems are taking toward the issue, is the problem. Burnout is merely a psychological term describing a state where demands have exceeded capacity leading to an unhealthy state in the individual. Generally, burnout can occur because demands are too high, capacity too low, or both.
“Every system invests in nurse retention – how many have a “physician retention” program?”
We continue to strip the joy out of practicing medicine by overloading physicians with pressures, frustrations and administrative tasks. We characterize the problem as the capacity of the individual and provide superficial solutions – mindfulness and resilience training, dry cleaning services, healthy living education – all while ignoring the underlying demand issues. It’s no surprise that the medical community has heard enough about burnout.
Chief Wellness Officer?
Now the concept of the Chief Wellness Officer is coming under fire. There was a noble intent to the idea – “The emotional well-being of our providers is so important, we’ll create a C-Suite role for someone to focus on nothing but that!” The problem, again, is that the definition of this role has not, generally, included attacking the underlying demand issue.
Physicians see it as just a bigger, more high profile, more expensive, band-aid. One hospital leader recently told me he thinks they really need someone in this role but the medical staff balked at the idea. Maybe what we need is a “Chief Physician Success Officer” – or to redefine the CMO role. Someone in the system needs to:
- Champion the physicians.
- Aggressively work toward solutions that let physicians practice medicine and focus on quality.
- Implement solutions that think about “wellness” more globally – physicians will be “well” when they have the resources and support they need to succeed, on a daily basis and in their career. (But don’t do away with the healthy living advice, dry cleaning, new lounges, and mindfulness training resources – those things have some value.)
- Create a culture where physician retention and success are top priorities. Every system invests in nurse retention – how many have a “physician retention” program? What comes from a nursing retention program? Solutions to attract the best nurses; Solutions to allow nurses to provide better patient care; Resources for nursing career development, and; Engaging nurses – leaders and front line – in solving problems.
- Ensure that the medical staff NEVER feels that its concerns are being ignored or that any initiative begins without their buy-in. Administrators would never think to discuss, plan or implement ANYTHING without engaging nurses, but are surprised when physician leaders push back against some program they are only hearing about after 6 months of planning!
- Focus on re-engineering the practice of medicine, including the business case for providing resources, rather than merely heaping more and more tasks on an already unreasonable workload.
Fight about What to Call it… or Solve the Problem?
I’d encourage us to spend less energy attacking the semantics and more redefining, and solving, the problem. I’ve seen a push recently to use the term “moral injury” and I appreciate the idea. I think people can be “burned out” as that term is really defined, without being “morally injured” but that for some, the latter term does, indeed, fit – but you needn’t be as traumatized as a war veteran to need help.
Now we are going to argue about “Chief Wellness Officer.” Perhaps we need to think about not a single person, (and a team supporting him or her), in every organization, that is tasked with ensuring physician performance, success, and career satisfaction – a Chief Physician Success Officer? Just an idea . . .