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Analysis

How You Should Think About Solving Physician Burnout

By Christopher Cheney  
   April 18, 2019

At health systems, hospitals, and physician practices, one-dimensional approaches to burnout are unlikely to succeed.

Physician burnout is a multifactorial phenomenon that requires a multifaceted response, a recently published white paper says.

Recent research indicates that nearly half of physicians are experiencing burnout symptoms, and a study published last October found that burnout increases the odds of physician involvement in patient safety incidents, unprofessionalism, and lower patient satisfaction.

The Chicago-based Chartis Group's recent white paper calls for healthcare organizations to take a broad approach to solving their physician burnout problems, an author of the report told HealthLeaders.

"When single-threaded solutions are executed in isolation or without an understanding of the full set of factors that are contributing to this epidemic, the impact can be limited and short-lived," said Tonya Edwards, MD, a principal in the I&T Practice at Chartis.

Several factors are often at play when a healthcare organization is experiencing alarming levels of physician burnout, she said.

"What we have tried to do is put together an approach that looks at many of the factors that contribute to provider burnout, including workplace overload, lack of control, breakdown of community, inefficiency, and poor leadership practices such as lack of respect and setting unrealistic performance expectations."

Two-pronged strategy
 

The white paper has a two-part framework for addressing physician burnout:

1. Operational dimension: At the grassroots, burnout mitigation efforts include process redesign such as streamlining of workflows, assessment and reform of care-team models such as staff fully practicing at the top of their licenses, and optimal use of technology such as realizing the full potential of the electronic health record.

2. Transformational dimension: At an organizational level, Chartis' approach focuses on leadership such as whether senior leaders involve physicians in decision making, culture such as fostering an environment that values collaboration and mutual trust, and engagement such as whether performance expectations well-articulated and understood.

"The first thing that needs to happen is a listening tour. Particularly after joining large organizations, providers feel like administrators are making all of the decisions, and there is a significant loss of autonomy. Physicians no longer feel respected," Edwards said.

Implementing burnout solutions
 

Every healthcare organization should design physician burnout mitigation efforts that are carefully crafted, Sue Fletcher, engagement manager in the Performance Practice at Chartis, told HealthLeaders.

"We believe we have to assess all of the factors, then tailor the solution based on the unique needs of physicians and the specific setting. The needs of primary care physicians are going to be unique and different compared to those of hospitalists or surgeons," she said.

Imposing physician burnout solutions on a healthcare organization rarely works, Fletcher said. "We have partnered with organizations to assess the specific needs of physicians—working with the care teams and working with the physicians to understand the factors that are causing burnout. Then we work directly with the physicians to figure out observable improvements in their experience."

Establishing and tracking metrics is crucial for a successful physician burnout initiative, Edwards said. "A key factor is making sure we are making measurable improvements. We have to identify key performance indicators. We have to show improvement over time."

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

Recent research indicates that physician burnout is raging at epidemic proportions.

A Chicago-based consultancy urges healthcare organizations to take a broad approach to burnout and to enlist physicians in the effort.

Establishing and tracking metrics plays a pivotal role in physician burnout initiatives.


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