I’m a physician and the son of a physician. I went into medicine because I wanted to help people get better and stay well. Somehow along the way, I got worse. Five years ago, I hit a wall, and admitted to myself that I was burned out.
My joy of practicing medicine had faded. I was overloaded with countless hospital initiatives and committees. I felt like I was letting down my patients, my colleagues, and my family. My most important relationships and my own sense of health and well-being were eroding. In my mind, I had become a victim of the machine of medicine, putting myself and the people in my personal life at the end of the line.
Despite this, I never entertained the idea of quitting. That is part of the dilemma of physician burnout. By and large, you don’t make it through the gauntlet that is medical training by adopting a mindset of quitting. Unfortunately, many physicians check out without leaving the profession, which jeopardizes quality, safety, and the patient experience.
Determined to remain engaged as a doctor, I began working with an executive coach. This helped me gain more clarity about what was important to me as a physician, as a father, as a friend. It also made me recommit to my life’s work.
I knew I wasn’t alone in feeling burned out. Doctors all over the country are expected to deliver world-class clinical care while trying to keep up with the economic, technological, regulatory, payer, and organizational shifts that make being a doctor harder and harder. The ever-increasing demand for our time and availability, the way we are currently paid, the changing technology, and the advent of patients acting more like true consumers all contribute to this phenomenon. Physician burnout is a silent epidemic that poses serious challenges to patient health and our health care system.
At Novant Health, where I work, it became clear that burnout threatened the organization’s ability to consistently deliver quality care to the patients we serve in North and South Carolina, Virginia, and Georgia. But we didn’t talk about it, especially the physicians. Based on my personal experience and newfound clarity, I suggested to our executive team that we address burnout head-on, with efforts to reverse it and to prevent it.
In partnership with my executive coach, we created a comprehensive program to help other physicians achieve better work-life balance; develop their leadership skills; boost their engagement, resiliency, and wellness; and find more fulfillment in their professional and personal lives.
The Novant Health Leadership Development Program focuses on self-awareness to help doctors better understand their own patterns of thoughts, feelings, and behaviors. It guides them to see more clearly what they value most and reclaim why they initially chose the profession — both of which can help them better cope with the mounting pressures on today’s physicians. The program is completely focused on the individual, not the system.
While the program is voluntary, we encourage our health care providers to take advantage of it and see it as an investment in themselves.
Since we launched the leadership development program in 2013, more than 500 physicians have taken part. It has had more of an impact than any of us thought possible. In a survey of our clinic and acute care physicians last year, those who participated in the program scored 50 percent higher than nonparticipants on measures such as personal fulfillment, alignment with Novant Health’s mission and vision, and engagement and positive attitudes towards the organization.
Just as important, participants — and sometimes their family members — have told us that the program has saved their careers and, in some cases, their marriages. Here is what two of the participants have to say about the program:
“My life changed significantly since participating in the physician wellness program. Like many, I was frustrated and overwhelmed both personally and professionally. By sharing experiences in a nonjudgmental and supportive atmosphere, I was able to gain insight, rejuvenate, and begin to improve my future. Because of this program’s tools and guidance, I have learned how to take control of my happiness and have a much brighter outlook overall.” — Dr. Barbara Meyer
“This program gives physicians a space to let their guard down, look inside themselves, and allow us to realize the importance of personal wellness. As a result, I can say that I am a better physician, friend, father, husband, and son.” — Dr. Ehab Sharawy
The program’s success has prompted us to start earlier. We now match physicians new to Novant Health with an experienced provider to offer connection and support, both personally and professionally. We also incorporate aspects of the program into on-boarding sessions for new clinicians.
Other efforts to improve physician engagement and prevent burnout include investing in the leadership capabilities of physicians in each of our practice sites; providing tools to promote authentic and empathetic communication; and openly discussing the changing roles of nurse practitioners and physician assistants in health care today.
As health care organizations across the country redesign their operations to meet the demands of a new landscape, they should not ignore physician burnout. If burnout is effectively and respectfully addressed, health care organizations can create environments that help physicians and other providers achieve a healthy work-life balance while providing the highest quality care to their patients.
Tom Jenike, MD, is chief human experience officer and senior vice president at Novant Health.
I don’t see anything for nurses regarding burnout mentioned here. What is being done for them?
Thank you.
As a RN then PA, I was witness to many Dr.s, nurses and midlevels who were suffering from burnout, or heading there. At the age of 53 I was diagnosed with a severe medical condition that ended my career. Unfortunately the only provider that specialized in my problem in a 4 state area was suffering from burnout and his midlevels were instructed to try to get patients to go elsewhere after all of the expensive testing was completed (about $80K worth of testing). it was so bad that the midlevel I was seeing was falsifying the records recording our visits to cover up what really went on and withdrew care abruptly when accepted practice is to wean it when a patient is TPN dependent. This resulted in a hospitalization and the TPN being restarted so that it could be properly weaned. I was a clot former to the PICC lines so I knew it had to be stopped which I discussed with the midlevel and asked for help and time to do so, however when the line need replacement she refused to order a new placement and stopped the TPN without weaning it. None of this was documented in my patient record. instead she reported that I refused to comply with recommendations and called to report I was seeking care elsewhere. The date of the amendment to the record was while I was in the hospital form complications from her failure to follow accepted practice for weaning TPN, especially since I was also on coumadin so the abrupt withdrawal of the vitamin K in the TPN sent my INR to 11. So as a witness to caregiver burnout and a victim of caregiver burnout I have a very unique perspective on it.
GREAT point!
This was in reply to mrhdoc’s post
This is pertinent to every profession. I appreciate the discussion and honesty of those who are commenting. I highly recommend coaching, regardless of the outcome, as a way to clarify personal, professional and life/balance goals.
Wishing you all health and worklife-balance and ongoing contributions to the health of our patients and society.
I am an RN and have worked at a NC Novant Hospital for 16 years. I can totally relate to this article as I think this is a dilemma among many nurses. It would be great to have a program like this for experienced nurses and new grads. Also, to consider 6-8 hour shifts to retain older seasoned nurses that can nurture and mentor new nurses. Even though we go into health care to help others, the constant pace, long hous, low staffing ratio, and minimal support, creates an environment of rapid burn out and/or rapid turn over! If Novant Health developed a program like this for nurses to incorporate into their day, they could become the top echelon of healthcare employment.
When I left training to go into practice , I received some advice from a senior
physician: “Only go to half your committee meetings. Those committees are formed either to support an idea already decided by the CEO or to deal with problems that have no solution.In either case you are not needed.”
It worked for me.
This was a disappointing article. The issue is not about burnout. In simplest of terms, the issue is out and out abuse. Who in their right mind would suggest to any human being that is living in an abusive relationship that they should just simply change their mind set, change their thought process about how the world works, and adopt a new perspective so their relationships are more tolerable so they are deluded into feeling satisfaction? Common sense dictates that a person cannot flourish in an abusive relationship and the solution is to leave that relationship. The business of Medicine can no longer dictate the paradigm of how physicians and healthcare workers go about delivering and documenting patient care. They have failed miserably and it is time that we start pushing back and stop putting up with nonsensical busy work that takes us away from our primary responsibility which is spending time with other human beings to help them make the best decisions for themselves in respect to Health and Wellness.
Wow, you have hit the nail on the head. Your analysis is right on
I’ve been well beyond burn out as a resident at a high level academic place. But now that I’m in business for myself, burnout seems impossible. Of course, frustration is common given EMRs, meaningless use, employees, and our legal environment. My collegues who work for the know-nothing hospital admins feel devalued and trapped. By consolidating physicians within organizations that don’t value them, present them Press Ganey scores like they matter, force them to churn more, use EMRs, and take part in administrative tasks without actual decision making capacity, the system grinds them down. All the conferences on personal growth won’t change that.
Break up the medical cartel. Allow innovation and competition. Get docs out of the job of being prohibition enforcers and agents for social change. Push government out and bring back market competition.
Nicholas Martin, I think you mean get the insurance companies out of health care.