Culture, Leadership, and Physician Burnout
Glassdoor recently released “Best Places to Work 2020”. Glassdoor research has found the top three indicators of employee satisfaction are career opportunities, trust in senior leadership, and culture and values. Of the top 100 large companies, six healthcare organizations made the list:
- #19 MD Anderson Cancer Center
- #28 Mayo Clinic
- #62 St. Jude Children’s Research Hospital
- #72 Massachusetts General Hospital
- #91 NYU Langone Health
- #99 Northside Hospital
Culture – Deconstructed
In the workplace, use of the term culture is ubiquitous. We all have a general sense for what culture means, but pressed to articulate the definition, there’d likely be wide differences in the way it’s described. Simply put, the definition of culture is:
“The way we do things here”
It’s a collective mindset. Think of culture as a verb. The evolution of culture is based in actions. An organization that is seeking to change the overall workplace culture to reduce physician burnout, should do so with concrete, tangible actions. Yes, words too. Words and actions.
Captain of the Ship
Culture change starts at the top. To impact physician burnout, organizational leadership should express a clear commitment to physician wellness. Start with acknowledging that burnout is a problem and that the organization cares about the well-being of their physicians – from the highest level in the organization. By prioritizing physician well-being, the organization is making a strong statement about its commitment to their physicians.
Driving improvements in physician well-being will take time, effort and financial commitment – like any similar effort to improve quality or safety. Prioritization of physician wellness is key in order to make progress. Include “Physician Wellness” in your organization’s strategic plan. Include scores for physician burnout in organizational success metrics.
Organizations will also need to create the leadership infrastructure to drive improvement, starting with a physician wellness champion. Many organizations designate a Chief Wellness Officer, for example.
Voice of the Customer
Business 101: listen to and act on the voice of the customer – in this case, your physicians. Create open communication pathways. Create forums for bi-directional communication exchange between the C-suite and physicians – townhalls, newsletters, videos, face-to-face meetings, management by walking around (rounding), etc.
Interventions to improve communication between physicians and staff has shown to impact physician satisfaction. Examples would be team huddles or the creation of standing monthly meetings where issues such as personal challenges, work-life issues, or difficult patient care management problems are discussed.
Give physicians as many venues and methods to share their voices as possible. Keep in mind that there are multi-modal methods to communicate that may vary across age groups.
Open communication between physicians and the highest level in the organization creates trust and establishes the foundation for a partnership between physicians and leadership to work on burnout.
Learn from Others
Medicine and the scientific method are based in evidence. Quality improvement initiatives are most efficient and cost-effective when we replicate others’ successful tactics.
When looking at the list of top places to work, I immediately ponder what they’re doing right to make their organization a top tier place of employment. Interestingly, the CEO approval ratings for each of the six organizations listed averages 92%. St. Jude Children’s Research Hospital’s CEO’s (James Downing) approval rating is an astonishing 99%. Capt. Of the Ship. Culture starts at the top.
While we do not know the rate of burnout of physicians within St. Jude or others on the list, the national rate among pediatric oncologists is about 40% and 44% all specialties combined. With an approval rating of 99%, it’d be extremely valuable to understand the voices of St. Jude physicians. What are they expressing as general attitudes towards the organization and leadership? Also, what are Downing’s management styles, practices, and system infrastructure that seems to result in the highest approval rating, not only in healthcare, but all industries. A great success story….