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Leadership accountability may help decrease physician burnout
CHICAGO — For university leadership, quantifying the bottom line in revenue loss due to physician burnout helps instill the importance of faculty wellness programs, Anita Blanchard, MD, associate dean for graduate medical education at University of Chicago, said during the American Society for Dermatologic Surgery annual meeting.
“Burnout doesn’t just begin when you become an attending physician,” she said. “It happens as early as medical school. There’s something about what we’re doing with training; in some ways, our system creates the problem.”
In a survey conducted at Stanford University, 21% of physicians with symptoms of burnout left the institution within 2 years vs. 10% of physicians with low burnout symptoms, Blanchard said. This translated in $15 million to $55 million for the institution in a 2-year period.
Blanchard added that a lack of control in the workplace can be a big driver of burnout. “Our values are not always in line with those we work for.”
Following the Stanford model, Blanchard and colleagues looked at a 5-year period at the University of Chicago of those who resigned or retired. They found that it costs $250,000 to replace someone and make up for the lost revenue.
“Even in a conservative estimate, at least $15 million was lost in our institution. I think that really resonated with our dean and CEO,” Blanchard said.
To promote resilience and wellness at University of Chicago, Blanchard and colleagues formed a physician engagement steering committee, focus groups on key areas and conducted an institutional survey.
“We had to regularly meet, make responses and re-calibrate,” she added. “You don’t just listen and do one thing. You are constantly reevaluating.”
The three areas of focus they identified were:
- transparency and trust in the leadership;
- wellness and resiliency; and
- ease of practice.
“People didn’t feel the institution was responsive to their feedback and they weren’t competent that the leadership valued them,” she said. “People also felt unable to disconnect from work, unable to free their mind about work and sometimes losing sleep over work issues. Finally, people felt their departments weren’t adequately staffed, that it was too hard to schedule and see patients and they didn’t have enough input in the decision-making process.”
To improve social interactions with faculty, the university brought back the physician lounge. It also improved access for faculty to get care and make appointments.
The university continues to survey faculty to ensure any issues are fully understood.
“The dean and chief medical officer are being held accountable for these changes, which I think is making sure these things really happen,” she said.
To improve leadership visibility, the university instituted a monthly lunch with leaders and increased the number of town hall meetings.
“Trust and transparency might be the hardest thing instill. The way we are addressing that is with our physician leadership, the lunch with leaders, by developing a leadership council of physicians, these are not department chairs, these are faculty who are interested in participating in shared governance,” Blanchard said.
“We are leveraging preexisting resources across faculty, residents and nursing to create new initiatives,” she said. “We are letting nurses, resident and program director decide on projects, plan these projects and fund way of improvements. What we found is letting residents and nurses solve their problems on a unit-based level is improving the way they feel about their positions.” – by Abigail Sutton
Reference:
Blanchard A, et al. Physician burnout and wellness. Presented at: American Society for Dermatologic Surgery Annual Meeting; Oct. 24-27, 2019; Chicago.
Disclosure: Blanchard is employed by the University of Chicago.