Transcript from a recent interview with Dan Shapiro, Ph.D.
Dr. Shapiro is a Clinical Psychologist with over 20 years of experience treating physicians and executives while working in the malpractice space. Throughout the following conversation, Dr. Shapiro, a member of the SE Healthcare team of consultants, offers valuable insights from his time working with hospitals, clinics, and physician groups to assess and ameliorate physician and APC burnout.
SE Healthcare: The concept of Physician Burnout isn’t new to healthcare, but it seems like it’s come to the forefront of conversations much more in recent years. Why is that?
Dr. Shapiro: The physician burnout rate has been worsening, dramatically, in a short period of time. A widely quoted statistic shows a 9% increase in only a year.
SE Healthcare: Everyone feels fatigue in their profession from time to time. Why is it different in healthcare? What are the biggest concerns surrounding Physician Burnout that make it more critical to study in healthcare as compared to other fields?
Dr. Shapiro: Healthcare isn’t actually different from other professions in which the consequences of burnout are dangerous to others. Air travel, for example, has been made safer by resting pilots and crews.
Because burnout is associated with poorer safety, worse patient satisfaction, more malpractice claims, and turnover, health care leaders are increasing attention and investment in this challenge.
SE Healthcare: How does a physician know when they’ve reached the boiling point and their level of exhaustion is starting to impact their work? Are they typically aware, or is it something that often goes undetected until it’s too late?
Dr. Shapiro: I work as a Vice Dean of a medical school. We generally recruit medial students who have shown some resilience to overcome adversity, but then unwittingly teach our medical trainees to ignore their own needs in the service of their patients. As a result, they learn to ignore their own physical and psychological needs. By the time they are showing symptoms they are generally farther along the agitated spectrum than most people. It’s important to use inventories to measure burnout in physician populations for this reason.
SE Healthcare: What should healthcare organizations be on the lookout for in their team? What are the most obvious signs of Physician Burnout?
Dr. Shapiro: Stealing time (showing up late and leaving early), people who are agitated or irritable consistently, late charting, complaints of being or feeling overwhelmed, and symptoms of excessive stress. Obviously more serious symptoms, such as of substance abuse, are indicative of problems. That said, because we’ve trained physicians not to show their agitation, the only real way to know is to ask them using validated instruments.
Because we’ve trained physicians not to show their agitation, the only real way to know is to ask them using validated instruments.
SE Healthcare: Being proactive in any approach to combatting Physician Burnout is critical. Rather than waiting for symptoms to appear, what steps can be taken to prevent it from occurring in the first place?
Dr. Shapiro: Make our systems of care as efficient as possible, make practice easier to deliver, continue to improve the EMR, offer “over the shoulder” training for EMR efficiency, get physicians routine breaks, increase social opportunities with other physicians, keep staffing levels adequate, help with routine life challenges like chores, picking up meals, and daycare.
SE Healthcare: I’m sure you’ve seen some bad scenarios play out. Can you talk about one instance that really stands out, names and locations excluded, of course? Just to create a better, more concrete vision of the impact of Physician Burnout.
Dr. Shapiro: I started treating a physician soon after she was sued. She was burnt out. She ultimately had substance issues and suicidal ideation. She was gifted and the type of physician patients want – technically skilled and a great humanitarian. It was deeply painful to watch her descent. I later wrote a book about our treatment for Random House.
SE Healthcare: What should an organization do in the case that undetected Physician Burnout leads to an incident in which a patient or even a team member experiences harm in some way?
Dr. Shapiro: That would really depend on the specifics of the event. I’m afraid there aren’t simple general answers that apply across the board. In general, we try to keep our moral compass polished and clear and rely on it in these difficult situations.
SE Healthcare: Do you see signs that diagnosis of Physician Burnout is improving and resulting accidents and other harmful incidents are declining?
Dr. Shapiro: Unfortunately, not yet. We are just starting to get a handle on the full extent of the problem and most large institutions lack a cohesive strategy beyond, “offer meditation classes.” EAP’s are generally understaffed and poorly utilized by physicians who don’t trust them, and burnout is on the rise rather than abating.
SE Healthcare: Thanks so much for taking the time to talk with us about this important topic. You’re doing some impressive work that’s critical in making advancements in the way the healthcare industry approaches Physician Burnout. Before we wrap up are there any last pieces of knowledge you’d like to offer the readers?
Dr. Shapiro: The good news is that many interventions designed to ameliorate burnout can work – and they don’t need to be expensive. That said, Band-Aids, such as overly simplistic wellness programs focused on exercise or yoga are unlikely to move the needle.