Managing Physician Well-Being and Burnout: A Conversation with AdventHealth
Healthcare worker burnout is real. That is why health systems are working to lessen factors that drive frontline staff out of the field.
Edward Shin, MD, the CEO and co-founder of Quality Reviews spoke with the Physician Well-Being team at AdventHealth. That includes Leila Durr, PhD, Mary Dijkstra, and Michael Torres, MD, MBA, FAAPL. They started the Physician Well Being program in February 2020. Psychologist Leila Durr has made the mental health of frontline staff a priority since the 1990’s, starting with spiritual support aided by chaplains. “We wanted to also provide the mental health, the emotional mental support for these healthcare providers,” she explains. “Given the epidemic of physician burnout that was already happening long before the pandemic, we really wanted to just make that more of a priority.”
“Healthcare is a team sport.”
AdventHealth employs many strategies for improving burnout rates for clinicians, as well as creating a less stressful atmosphere. They use team building events to create a healthier work environment. Dr. Michael Torres explains, “Healthcare is a team sport, but we teach physicians to be islands.”
Torres says that a major strategy in getting to the bottom of negative behavior means approaching wellness. This combats the need to immediately jumping to penalties. Helping staff to unpack their negative encounters can shed light on the work environment, not just a clinician’s risk of burnout.
Durr often brings in therapists and works on de-stressing techniques as necessary. A newsletter also goes out to departments to remind staff that support is available.
“Burnout is not a diagnosis, and it should never be approached like that.”
Durr’s background is psychology, and she notes that working with doctors is a different experience than working with other patients. She believes that healthcare worker burnout is stigmatizing for many, because it implies that something is wrong with you. “Doctors have personalities that are driven to perfectionism, and being thorough and committed to their patients.”
A major part of that perfectionism comes from the expectations that society has. We tend to think that if you have a diagnosis, there is a treatment, and that treatment will cure you. However, that isn’t always the way medicine works. Not only that, but moral injury and not having the power to perform the best procedure immediately (without insurance and procedural barriers) is taxing as well. COVID-19 has made that even more difficult.
Because of this, Durr spends quite a bit of time reiterating the importance of self-care. “Even though they preach a lot of self-care to their patients — and they preach very correctly — they don’t practice it for themselves. So one of my soap boxes that I get on with our physicians is that self care is part of patient care.”
“Personal resilience is only 20% of what causes burnout in healthcare.”
Durr explains that, while doctors do need to practice self-care and maintain boundaries, organizational factors make up 80%. The organization’s practices may be a huge part, but so can a trickle down effect from the national level all the way down to a physician’s own teammates.
She encourages doctors to find out about resources available to them, and to communicate concerns with their higher-ups. Further, these higher-ups should already be developing strategies to ease the burdens of the frontline workers.
Torres’ recommendation to combat healthcare worker burnout is setting boundaries to protect your mental health. “I encourage physicians to actually draw lines to what they’re willing and not willing to do, and what they are willing to get involved with.”
He says that helps the team to carry each other, instead of one person silently suffering through a heavier load; though he acknowledges how tough expressing your needs can be. “It takes a lot for someone to be able to admit that they don’t have the bandwidth.”
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