A chief medical officer for physician experience is tasked with boosting physician well-being and experience.
To address physician burnout and physician well-being, Altamonte Springs, Florida-based AdventHealth is focusing on the broader concept of physician experience.
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 AdventHealth’s Central Florida Division, Omayra Mansfield, MD, MHA, has been charged with boosting physician experience. She is an emergency medicine physician, chief medical officer for AdventHealth Apopka hospital, and chief medical officer for physician experience at the Central Florida Division.
HealthLeaders held a recent discussion with Mansfield about AdventHealth’s approach to physician burnout and physician well-being. The following transcript of that conversation has been edited for brevity and clarity.
HealthLeaders: How is your role different from a chief wellness officer?
Omayra Mansfield: I have two project managers that I work with. I have one manager for experience projects such as physician recognition, scribes, and leadership development. Those are experiential projects that we are moving forward with our physicians.
I have a second project manager who focuses specifically on the well-being and wellness of the medical staff. The well-being project manager focuses on the core elements of physical health, emotional health, spiritual health, and psychological health. For example, the well-being project manager can pursue opportunities for connections with families and other opportunities, like going to a kitchen to learn how to cook healthy meals.
The key is the three of us work collaboratively. Each of the project managers feeds into the other. Traditionally, chief wellness officers have focused more on the wellness space. What we have added is the experience project space. But there is overlap, and that is the beauty of having two project managers.
HL: What are the primary elements of physician experience at AdventHealth?
Mansfield: I define physician experience as what it is to be a physician at AdventHealth. What is your experience from day one? From the minute that you decide you want to join AdventHealth, what is your experience? How is it to navigate the system? How easy is it to be credentialled? Then once you are a medical staff member, what is your experience day-to-day? What is it like to be on call? How do people communicate with you?
All of those elements will ultimately contribute to or detract from a physician’s personal well-being.
The experience is how the physician interfaces with AdventHealth and all of the parts of the health system, our patients, the rest of the staff, and nurses. The primary elements of physician experience are understanding that concept, then what we have done is broken it out to say, “How would you define each of those components?”
Well-being is probably by far the most important component of physician experience because well-being is not just your well-being at work—it starts at home. We want to look at physicians as whole individuals and attend to their well-being at home. Is your work distracting you too much? What are we contributing to in your personal life? How are we enhancing your personal life? How are we engaging your family in your experience at work?
The way we break up the rest of physician experience is related to the vision we have as a company and what we aspire to be by 2030. We want to be known as the company that looks at patients as whole individuals and healthcare as one facet of being a whole individual. I’m looking at my physicians in the same way.
HL: Are there guiding concepts for physician experience at AdventHealth?
Mansfield: We have four service standards—love me, own it, keep me safe, and make it easy. These service standards apply to physician experience.
One of my elements of experience for physicians is what am I doing every day to show them that we love them. For example, what are we doing to make them feel like they are part of the campus and not siloed as a medical staff member? What are we doing to show them that we love them and their families? What are we doing at the campuses to organize family events?
From the "own it" piece, we want to know, what are the rocks in their shoes? There are a lot of big things that I can do to enhance physician experience—I can help their transition to our new electronic medical record. But in the end, there are little rocks in the shoes that each doctor has that we need to identify, because we can do big things, but if those little rocks are still there, the big things don’t matter as much as they should. It can be little things such as not being greeted when you walk onto a medical unit. It can be helpful to have someone say, "Good morning, Dr. Jones. How are you doing?"
"Keeping me safe" includes if doctors are facing hostile situations in the work environment, we are supporting them. If they are faced with a challenging patient, we are supporting them. We want to make sure doctors have the tools and the resources that they need to provide safe patient care.
An example of "making it easy" is one of the things that we identified to love our physicians—recognizing physicians for exceptional care. We had a once-a-year opportunity to recognize physicians for extraordinary service at the end of the year during our medical staff banquet. But the question arose, why are we just doing this once a year? Our medical staff do extraordinary things every day.
So, we created a physician recognition program, where physicians can be nominated by anybody. There is a service excellence pin, and physicians can be recognized for meeting one of the four service standards—how they demonstrated "love me" or how they demonstrated "make it easy," for example. When a physician gets recognized, they get two pins—one that they can keep for themselves, and a second pin the physician is tasked with finding a colleague to award that pin to. It’s a pay-it-forward mentality.
The physician recognition program is crafted in the "make it easy" spirit. To date, we have had more than 700 physicians recognized in nine months.
HL: What is the primary benefit of a positive physician experience?
Mansfield: If we take better care of our physicians and make sure they are having a positive experience, by default they take better care of our patients. We know that burnout has a direct correlation to adverse clinical outcomes. For example, we know that medical errors increase if a physician is burned out compared to a physician who is not burned out. That is regardless of your tenure—you can be a resident or an attending physician.
HL: How do you measure physician burnout at AdventHealth?
Mansfield: There are two relevant things that we trend and track over time. One is our SCOR survey, which is a safety survey that we take as an organization that allows us to benchmark against other organizations. Part of the SCOR survey looks to the questions of reflections of your own burnout, reflections of team members’ burnout, and questions about your personal resilience. For the most recent SCOR survey, physicians had higher levels of reported self and team member burnout. But what gives me hope is that there were high reported levels of resilience.
The other marker that we use is physician engagement surveys. Looking through those and the comments, we have an opportunity to address the burnout of our physicians.
We use the SCOR and physician engagement surveys because they give us historical data, and they also give us something that we can look at objectively. But I also take the surveys with a grain of salt because there is also the reality of people with boots on the ground. We have a well-connected group of chief medical officers across the Central Florida Division. I rely on this group to give me their feelings about levels of burnout. There are the numbers in the surveys, but there is also the sense that you get from your campus.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
At AdventHealth, the guiding concepts for physician experience mirror the organization’s four service standards: love me, own it, keep me safe, and make it easy.
Physicians who have a better experience take better care of patients.
AdventHealth has two primary measurement tools for physician burnout: the SCOR survey and physician engagement surveys.