4 Qs with Christine Mackey-Ross & Linda Komnick on tackling physician burnout

Linda Komnick, senior partner and leader of the physician integration and leadership practice at executive search firm WittKieffer, and Christine Mackey-Ross, a former WittKieffer employee, shared their insights on remedies for physician burnout.

Note: Responses have been lightly edited for style and clarity.

Question: What are some actions health systems and physicians themselves can take to combat burnout?

Christine Mackey-Ross and Linda Komnick: First, systems can just acknowledge that burnout is real, so physicians feel validated and seen. Then they must investigate what is creating that lack of job satisfaction in their organization. Is it clinical load, clinic operations or electronic health records? Are physicians feeling connected to the organization and to their patients? You can't fix what you don't know is broken. Ask and listen.

Like all of us, physicians have personal responsibility for their mental health. There are usually personal stressors from life that give them less bandwidth than they used to have, especially when added to those of their professional complexities. These daily challenges move meditation, exercise, healthy eating and time with family from not just "that would be nice" into the "essential" category. Having a quiet room where you can meditate or eat your lunch without interruption helps. Maybe a five-minute huddle prior to clinic starting, where people can be acknowledged and the team can build more rapport and an understanding of where there are stress points and who can assist. These are options that can help, though of course, these are not a complete solution.

Q: How do you see the burnout issue changing in the next five to 10 years — either improving, getting worse or something else? Why?

CMR and LK: We think burnout is going to get worse for clinicians, especially for physicians over 50. This is not the model of practice they signed up for. They spend less time with each patient, see them from over the top of a small electronic tablet, and in many instances only see the sickest of the sick, because advanced practitioners are seeing the routine and minor cases. So they don't have the long-term relationships with patients that they used to, and let's face it, connection is vital to feeling you're having an impact and making the world a better place.

So you have a person who was trained to think they are responsible for all things attributable to their patients, and now they are essentially practicing "delegated care." What if something gets missed? And it does. This is part of the pressure on every physician, and there is no quick fix that won't take years to resolve.

Q: If it gets worse, what other steps can health systems take?

CMR and LK: We see organizations at the cutting edge of this issue beginning to assign an executive position — sometimes titled the chief wellness officer, chief physician wellness officer, or to give the chief clinical officer responsibility to help address the issue and advocate for physicians and caregivers. This isn't a cure-all, but it elevates the issue to the C-suite and ensures that physician wellness becomes ingrained in key strategic decision-making. This trend of a dedicated executive role started in some of the leading academic medical centers, and the general healthcare community will no doubt follow suit.

Q: If an organization doesn't have a lot of resources (such as a smaller healthcare facility like an ASC), what can staff do to alleviate burnout?

CMR and LK: These organizations can still acknowledge the stress, build a team that looks out for each other and really cares, pitches in when they see others overwhelmed, ensures vacation time, eliminates "busy work" and so forth. They can have team meetings where solutions from their suggestions are really implemented. Burnout at work is as much about not feeling appreciated or acknowledged as it is about being tired and overworked.

On that note, physicians need to have some control and autonomy in addressing these issues and improving their work lives. It's easy to suggest solutions for burnout, but clinicians need to have a say in what they want and need, rather than having solutions applied to them.

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