How ASCs can address burnout: Q&A with Cardinal Health’s Marvella Thomas

Burnout is one of the most pressing issues facing ASCs, especially in response to the pandemic. However, leaders do not always know what steps they can take to help their clinicians and staff reduce burnout and its effects.

Marvella Thomas, a senior consultant of clinical operations for ASCs with Cardinal Health, took the time to speak with Becker’s about burnout.


Question: How does the issue of clinician burnout differ at ASCs compared with hospitals?

MT: I think there is less burnout in the ambulatory space because working conditions are typically better than in the hospital space. The perception is that the ASC space offers less overtime, no on-call, and no or fewer night/holiday/weekend shifts. Clinicians may migrate to the ambulatory world thinking the job is easier and there is less stress. Although there are scheduling benefits to working in this space, you must realize that this is an extremely fast-paced environment with a marked focus on productivity. New hires are surprised by the complexity of procedures, volume of the daily schedule, and the pressure to do more with fewer resources. 

Patients are typically in good health, there are fewer exposure risks, and some procedures may be less complex. Some of this is changing with more procedures migrating to the ambulatory space. Segregation of specialties can also increase burnout if staff get tired of the same procedures.

Q: How does burnout differ between clinicians and staff? Should they be addressed with different methods?

MT: I think the causes may be closely related but physician burnout or loss due to burnout has a negative effect on your bottom line. It can be less time consuming or expensive to find a new clinician compared to finding a new physician. I see more causation from inefficient working conditions and supply chains. Not having supplies needed, not being able to find things, clutter, disrepair, and lack of cleanliness also lead to dissatisfaction in the workplace. If your center is clean, organized, efficient, and schedules run smoothly there will be less burnout. Providing perks like profit sharing or meals are appreciated.

A great example is looking at the physical condition of the facility. Everyone is extremely careful to make sure that the public areas are clean, offer amenities such as Wi-Fi, and are always well lit and tastefully decorated. Signage makes it easy to find their way around and find the amenities. But cross the “red line” and you may find a totally different facility. We need to remember that our staff and physicians are our customers as well and will appreciate the same amenities and concern for their comfort as patients and families do.

Q: What is your top advice for leaders looking to address burnout within their organization, especially in response to COVID?

MT: Strive to make your working environment as stress free as possible. Focus on cleanliness, organization, and efficiency. Provide perks when possible, such as space for personal time, snacks, meals, etc.

Give clinicians a voice and listen. An efficient supply chain greatly enhances the satisfaction of your team. Having the supplies they need and being able to access them easily reduces waste in both time and money.

It's important to recognize the additional stress on your staff in our post-Covid environment. They may have financial difficulties, spouses may be out of work, children are out of school and there are no resources to help with childcare. Be aware and be supportive. It may be possible to stagger hours to accommodate home schedules. Give them opportunities to share and listen to their concerns.  Make sure the workplace protects their health needs, both mental and physical. Recognition and discussion of the causes of burnout, as well as more emphasis on retention, give me hope for the future of the issue.

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