Physician burnout is tied to key performance indicators such as patient safety and care quality.
Four HealthLeaders CMO stories in 2024 looked at ways to promote physician well-being.
Physician burnout remains a concern across the country, and it spiked during the coronavirus pandemic. In a 2021 survey of physicians conducted by the American Medical Association, Mayo Clinic, Stanford University School of Medicine, and the University of Colorado School of Medicine, 62.8% of physicians reported experiencing burnout symptoms, which was up from 38.2% the previous year.
1. CCO: UW Health Following Best Practices for Physician Well-Being
UW Health stepped up efforts to promote physician and advanced practice provider well-being in 2017, when the health system conducted its first physician and APP well-being survey as part of Stanford Medicine's Physician Wellness Academic Consortium. UW Health has repeated the survey every two years since 2017, says Aimee Becker, MD, chief clinical officer at the health system.
"It is challenging to make meaningful change without having data and metrics," she says.
After UW Health started conducting the well-being survey, the health system committed to not only measuring wellness among physicians and APPs but also to acting on the measurements. UW Health developed a well-being committee that included physician and APP representation from all clinical departments.
"They were tasked with helping us as an organization to identify initiatives to improve physician and APP well-being," Becker says.
Most of UW Health's well-being improvement initiatives for physicians and APPs have been consistent with the Stanford Medicine Model of Professional Fulfillment, Becker says. The model has three domains: culture of wellness, efficiency of practice, and personal resilience.
Connie Savor Price, MD, MBA, is CMO at Denver Health. Photo courtesy of Denver Health.
2. Denver Health CMO Focused on Physician Burnout
Addressing physician burnout is fundamental to promoting patient safety and care quality, says Connie Savor Price, MD, MBA, CMO at Denver Health.
Denver Health has been working intentionally to reduce physician burnout for the past eight years. There is no silver bullet to address the problem, Savor Price says.
"There is not a singular solution to the problem, but we know we must work on it regardless of the challenges," she says. "We must try different things and make continued efforts to move the needle because provider burnout has a big impact on patient safety and quality."
A primary effort has been to address excessive workload and administrative burdens such as documenting clinical care in the electronic medical record, Savor Price says.
"One of our most successful clinician burnout initiatives that was launched about three years ago has been at-the-elbow support in using the electronic medical record, which is Epic," she says. "We have had Epic 'super users' who are very knowledgeable in how to use the EMR to make themselves more efficient work with other clinicians. These super users have been working with their peers to show them how to efficiently document clinical care."
3. How to Build a Program to Promote Physician Well-Being
After selecting a well-being measurement tool, Allegheny Health Network picked an established strategy for its wellness program. As was the case with UW Health, the health system picked the Standford Model of Professional Fulfillment.
Culture of wellness: The first step involves making sure that providers have multiple ways to reach out for help, says Thomas Campbell, MD, MPH, chief wellness officer at AHN.
Survey data showed that physicians are reluctant to reach out to AHN's employee assistance program (EAP) because they are concerned about confidentiality.
"We created a help line so physicians could reach out to internal behavioral health providers 24/7," Campbell says. "We now have an EAP program that does not use internal reporting tools if people are uncomfortable with our internal behavioral health resources. We also established external resources, where people could get help through our county medical society."
AHN also conducted leadership education to create a culture that included psychological safety, so that physicians could feel comfortable sitting down one-on-one with their leaders, according to Campbell.
"The primary focus of the leadership training was how to lead your physicians with wellness in mind," he says.
Efficiency of practice is an essential element of promoting physician well-being, Campbell says.
"When you have a workday where everything is working well, you are less likely to get burned out," he says. "You are likely to get out of work on time, to be more fulfilled in your day, and to make yourself a better person physically and mentally outside of work."
AHN's effort to improve efficiency has focused on the health system's Epic electronic health record.
"We have been trying to limit the amount of time physicians are on a computer to make their work more patient-centered," Campbell says. "We want physicians to spend less time at night—we call it pajama time—charting because they could not get to it during the workday."
To address this, AHN has formed teams of proficient Epic users to help physicians use the EHR more effectively.
"We call members of these teams IT officers, and these officers show physicians how to be more efficient in the EHR," Campbell says.
The health system has also adopted AI-driven ambient listening technology, which automates documentation during physician encounters with patients.
"We are trying to find ways to make the EHR work for the physician to promote a more efficient workday, create better documentation, and create tools that support better care," Campbell says.
Personal resilience: For physicians, teamwork is also tied to personal resilience and a commitment to wellness, Campbell says.
"We have found that resiliency is tied to the team around physicians, but physicians do need to keep an eye on their health and well-being," he says.
It is important to understand that personal resilience is individualized, Campbell says.
"What one person might need in terms of diet, sleep, hydration, and mental healthcare is often different than what another person might need to keep healthy," he says.
Campbell has found that his human resources colleagues and AHN's benefits offerings are crucial to supporting personal resilience.
"I have been looking at what programs that we have and what benefits that we have for those who may need help with issues such as weight management and addiction, including smoking cessation," he says. "We want to provide multiple ways for people to get the things that they need."
4. Houston Methodist's Chief Physician Exec Highlights 3 Strategies to Boost Physician Well-Being
Shlomit Schaal, MD, PhD, MHCM, executive vice president and chief physician executive at Houston Methodist, made physician well-being a top priority for 2024.
Schaal has also been focusing on the core approaches of the Standford Model of Professional Fulfillment.
"We want to create a culture of wellness for physicians at Houston Methodist," she says. "We do not want a culture where physicians feel pressured to see as many patients as possible as fast as they can."
“The second thing we are focusing on for physician well-being is the efficiency of practice," she says. "There are many things in the modern practice of medicine that take up a physician's time, and we want to redesign our processes to make sure our physicians are practicing at the top of their licenses, and they have support to do things such as coding, billing, and answering messages."
"The third thing is personal resilience," Schaal adds. "We know there are ways that we can help physicians increase their personal resilience, which is related to a culture of wellness and efficiency of practice."
Christopher Cheney is the CMO editor at HealthLeaders.
KEY TAKEAWAYS
Physician burnout spiked during the coronavirus pandemic, with nearly two-thirds of physicians experiencing burnout symptoms.
The first step toward addressing physician and advanced practice provider burnout is adopting a well-being measurement tool.
Many health systems are adopting the Standford Model of Professional Fulfillment, which focuses on a culture of wellness, efficiency of practice, and personal resilience.