Recognizing perfectionism, praising accomplishments reduces charting stress
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The keys to reducing stress associated with charting is recognizing maladaptive perfectionism, focusing on accomplishments and ‘only handling it once,’ according to a speaker at the Ending Physician Burnout Global Summit.
“I don’t think I have to tell you all of the impact of the electronic health record and what a large contributor the EMR is in the epidemic of burnout,” Gail Gazelle, MD, MCC, founding member of the Harvard Institute of Coaching, said. “What I find as a coach is that many physicians expend a lot of energy on things that they cannot control and with the electronic health record, sadly, what we can control is miniscule. What I want for each of you is to mobilize your energy toward the things that you can control and not dissipate your precious energy stores on the things that you can't.”
When you think about perfectionism in the profession if medicine, it is often rarely with a negative connotation because the desire to be the best possible physician fuels a growth mindset where challenges and setbacks are opportunities to learn. However, the lesser-known twin of perfectionism, maladaptive perfectionism, is much more common than anticipated. The crossover from challenging yourself in a healthy manner to setting unrealistic goals that leads to a fear-based mindset is detrimental to a physician’s well-being. Gazelle noted the only way to shift this behavior is to build a greater awareness of what is going on in the mind.
“The way to handle it is to really get to know it to the point that you can begin to spot when you are being a perfectionist. Once you bring it into full conscious awareness, you are much more able to work with it and actually realize you have a choice,” Gazelle said. “The standard needs to shift from perfection, to good enough. Something we all can do is our best, we can all do good enough; perfectionism is the enemy of well-being for all physicians.”
Going hand in hand with perfectionism, motivation is another key to reduced stress associated with charting. Gazelle noted that many physicians believe harsh words drive productivity although it is actually detrimental to the desire to do anything at all. Placing emphasis on praise for your accomplishments rather than focus on your failures not only increases ability, but prevents physician burnout.
The No. 1 hack for reduced charting stress is efficiency; Gazelle combats charting inefficiency by following the acronym ‘OHIO:’ only handle it once.
“There's only one of you and every minute in your day adds up. What I want for each of you is to get your charts done as efficiently as you can so you can go home and spend your time with your loved ones. When you only handle things once you dramatically reduce the amount of time spent, this is true for charting and for your inbox,” Gazelle concluded. “The more you get in the habit of only handling it once, your efficiency will automatically increase.”
Perspective
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The idea of “only handling it once” when it comes to EHR charts is very pertinent. However, EHR workflows are built in part to mitigate risk, not to avoid burnout for providers. What happens when the EHR prevents a provider from “only handling it once,” or everything has to be perfect? Risk and benefit shifts are required to address the burnout. Additional support will have marginal effects if the EHR itself is not designed to “only handling it once.” Organizations that succeed will be those that empower their providers at the EHR level to “only handle it once.”
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Gazelle G. Strategies for reclaiming your power in the midst of burnout and the electronic record. Presented at: Ending Physician Burnout Global Summit; August 24-26 (virtual meeting).
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