Bon Secours Mercy Health Focused on Physician Burnout

In terms of burnout, executive says healthcare organizations are in a "fragile state."

Bon Secours Mercy Health has a multipronged approach to addressing physician burnout.

Healthcare worker burnout was a top concern for health systems, hospitals, and physician practices before the coronavirus pandemic, and it has reached crisis proportions during the public health emergency.

Prior to the pandemic, burnout rates averaged in the range of 30% to 50%; now, average burnout rates range from 40% to 70%, a healthcare worker well-being expert recently told HealthLeaders.

At Bon Secours Mercy Health, physician burnout has increased during the pandemic, says Herbert Schumm, MD, vice president, and medical director of education and physician engagement at the Cincinnati-based health system.

"We do a physician engagement survey every fall, and through that we have our baseline burnout numbers for both our physicians and our advanced practice providers. We are pretty much in line with the national trends. When we compare early in the pandemic with last fall, year-over-year, we were up about 17 percentage points, which is consistent with national levels that are up about 21 percentage points," he says.

Awareness of healthcare worker burnout has increased dramatically, Schumm says.

"There are some practical reasons for this change. In particular, we have Lorna Breen, a physician who died of suicide at the beginning of the pandemic and received national attention. That raised awareness. Also, folks realize that healthcare professionals overall—nurses, respiratory therapists, physicians, and others—are experiencing burnout. Awareness is higher than it's ever been. When we look at some of the legislative work that is going on across the country, it is supportive of our healthcare professionals. It is also boosting mental health support for them," he says.

Tackling physician burnout

Bon Secours Mercy Health had several physician burnout interventions in place before the pandemic, including three programs, Schumm says.

Wellness: The health system has an employee wellness program that allows clinicians to make sure they are receiving healthcare and closing care gaps. The employee wellness program also offers the Life Matters program, which provides free counseling to employees and their family members, plus "convenience services," he says. "If you have a quick question about finances or a legal question, or you have a flat tire on the way to work, you can call them, and they take care of it."

Coaching: Bon Secours Mercy Health offers coaching to clinicians, Schumm says. "Some physicians might say, 'I don't need a counselor, but I am struggling with time management or struggling with closing my charts.' We offer life coaching—physicians can choose whatever coach they want."

Treatment: The health system makes sure clinicians have access to physician health programs in their states, he says. "Physician health programs are programs that help with substance use and behavioral health. They also help protect a physician while they are getting treatment. These programs provide treatment, it is confidential, and as long as physicians comply with the treatment, they can protect their license. We reached out to all of these programs in our states to make sure 1) that these programs were available to our physicians, and 2) make sure that our health benefits cover the service for our physicians. We make sure physicians have coverage for both treatment and for any short-term disability."

Bon Secours Mercy Health also has interventions to boost physician resilience, Schumm says.

"Within our Life Matters program and Be Well program, we have several options that clinicians can take advantage of. One example is Joyages, which is an app that can be used in real-time and on-demand, individually or as a team," he says.

"Another example is our employee wellness program has different activities that you can do with others on your team. You can do a challenge with others in your office that involves activities such as exercise or diet—something that can engage your whole team," he says.

The health system has a strong ethics program to support clinicians and foster resilience, Schumm says. "We often talk about moral distress as a factor in burnout. We have full-time ethicists who are available to discuss difficult cases and to give support to clinicians immediately. It helps to support clinicians and whatever needs they have in real-time."

Bon Secours Mercy Health has launched two clinician burnout programs during the pandemic, he says.

Psychiatric support: "About two months into the pandemic, a couple of our psychiatrists called me and said, 'What can we do to help our colleagues?' They got several psychiatrists together and offered to provide support 24/7 to any of their colleagues—simply a cellphone call away. There were 10 psychiatrists who made themselves available. They have had 300 physicians and advanced practice providers call them. Some just needed someone to talk to, some needed therapy," Schumm says.

Extending free counseling services: "We were able to provide free counseling for all of our associates and their family members. Early in the pandemic, we were able to extend this service to all of our physicians and advanced practice providers who were not our employees but worked in our hospitals. They were without mental health and supportive services."

The Coalition for Physician Well-Being has been a good partner for Bon Secours Mercy Health in addressing physician burnout, Schumm says. "They have a great program so you can measure your organization against about 50 standards to see how you are doing in supporting your physicians. During the pandemic, we were able to receive their Medicus Integra Award, which is a milestone. But more importantly, The Coalition for Physician Well-Being gave us standards for measuring ourselves and an opportunity to find out what we needed to work on more. We found out things that we were doing well that we had not recognized. For us, it helped us to pull our team together."

Gauging the state of healthcare worker burnout

Schumm says healthcare organizations are in a fragile state regarding burnout.

"To use a sports analogy, we are approaching the end of game and some players are injured. Everybody is tired. Some players are ready to go on—others are not. We need to give each other a little bit of grace. We are also in a society that is divisive and not open to conversation. To get past this point, we need to be able to talk with each other. There needs to be psychological safety, where we can have open conversations. We are in a fragile state, but we are also in a hopeful state. People are looking forward to not being in the pandemic. I was on a recent call with a chief clinical officer, and he said, 'Herb, we have zero COVID patients today.' It was a relief that we had gotten to that point for a day. That brings hope that we can push forward," he says.

Schumm is hopeful about physician burnout at Bon Secours Mercy Health.

"I am optimistic because I can see how we have been able to invest in resources to help our clinicians. I also see a profound interest in the mental health of our physicians among our senior leaders. Top executives don't only want to know the state of burnout—they want to know what they can do. They want to know what is meaningful and how to approach it. I am optimistic because people are engaged and are looking at what we can do to support each other," he says.

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