Why collaboration is the key to solving health care burnout [PODCAST]

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We’re joined by Wael Saasouh, an anesthesiologist; Lisa Scardina, a health care executive; and Kim Downey, a physician advocate and physical therapist, to discuss the urgent need to restore human connections in health care. From tackling clinician burnout and moral injury to enhancing collaboration across silos, our guests share powerful insights on creating a supportive environment that values well-being and deepens the physician-patient relationship.

Wael Saasouh is an anesthesiologist. Lisa Scardina is a health care executive. Kim Downey is a physician advocate and physical therapist.

They discuss the KevinMD article, “Fighting burnout with deeper human connections.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome back, of course, Kim Downey. She is a physician advocate, and she brought together Wael Saasouh. He’s an anesthesiologist. And Lisa Scardina, she’s a health care executive. Today’s KevinMD article is “Fighting burnout with deeper human connections.” Everybody, welcome to the show.

Wael Saasouh: Thank you, Kevin.

Lisa Scardina: Thanks, Kevin.

Kevin Pho: All right, Kim, always start with you. Thank you again so much for bringing such a diverse intersection of people across the health care spectrum together. We’ve had fascinating conversations. So what brought Wael and Lisa together? How did they connect with you?

Kim Downey: So Wael was one of my early connections on LinkedIn a year ago June, and we Zoomed and appreciated the work that we were each doing. And we Zoomed again later, and we’ve kept in contact. And I met Lisa a year ago last summer, as I was invited to be part of the traction team for Medicine Forward. And we had a retreat this summer, and I got to spend a whole weekend with Lisa and the others, and it was amazing.

Kevin Pho: Perfect. And Wael, Lisa, I’m going to ask each of you just to briefly share your story and journey. So Wael, why did you go first?

Wael Saasouh: Sure. Good to be here. Thank you. I’m originally an anesthesiologist from overseas, and I moved to the States about ten years ago, where I had to redo my residency, get into board certification. I’m currently an anesthesiologist in Michigan and a researcher and a business owner on the side, and then trying to get into the innovation and into the human aspect of medicine.

Kevin Pho: All right, Lisa, tell us your story and journey.

Lisa Scardina: Thanks. I’ve been working in health care for over twenty years as an administrator based in Portland, Oregon. Just have a real affection and affinity working with and for physicians over the years. My current role is as brand and partner development lead for a physician and APC recruitment firm that’s a part of the Providence health system. And so I think part of what’s informing my perspective is really looking at the physician supply and demand across the country and the pressures on physicians in the different care settings and kind of what organizations can do about that.

Kevin Pho: All right, so Lisa, let’s start there. From your perspective as a physician or clinician recruiter, tell me some of the trends that you’re seeing and how burnout may influence those trends.

Lisa Scardina: Sure. So I think it’s pretty well known that there’s a shortage, and there’s really just a crisis with the health care workforce, coming off of COVID-19 or otherwise. And so for us, we place about 1,400 physicians and APCs across the country in about a hundred different settings. And so I think, sitting at that intersection between a health care system and a physician and an APC, we really have an ear to the ground in terms of what physicians are looking for and how health care organizations may be kind of taking new approaches in order to address the burnout issue, creating environments that are more conducive to having better work-life balance, different approaches to wellness, and, frankly, more autonomy for physicians in deciding their schedules and different compensation models.

So the trends that we’re seeing is that there’s a shortage. There’s critical access hospitals in particular; we’re seeing those closing based on a lack of ability to recruit physicians. And so it really does put pressure on the organizations themselves in order to create environments that are conducive for physicians to want to work there.

Kevin Pho: Lisa, just to follow up on that, you mentioned a variety of potential solutions to help with that burnout, whether it’s empowerment, work-life balance, more control over their compensation schedule. From your discussions with clinicians, which one of those potential solutions tends to resonate more in them accepting a job at your facility?

Lisa Scardina: It’s interesting. I don’t know that there’s any one solution. I think one of the stats that’s really curious to me is that compensation is really no longer the number one issue that physicians are really considering. They really do want to find a healthy work environment. And so I think the reasons for selecting a particular practice setting really vary. We’ve done research and have different segments of different kinds of motivators for physicians, and I think it really takes a multi-pronged approach for an organization to have some of all of that going on.

Investments in technology to aid the physician in the work that they’re doing within the EMR or otherwise. I do think that the cultural aspects, providing leadership development or cohorts of physicians who are coming together to talk about what their interests are, I mean, I think it’s a little bit of all of those. I don’t know that I have a kind of a singular point. I think it really takes work on all fronts.

Kevin Pho: Wael, in your contribution, you talk about the need to prioritize physician-patient connection in organizational decision-making, right? So Wael, from your perspective, what are some steps that organizations can take to prioritize these relationships while also balancing operational and financial constraints? What are some of your ideas?

Wael Saasouh: There’s a lot to be said here. And to follow up on what Lisa was saying, there is a problem, and everybody recognizes it, but you often find that it’s very complicated to implement a very simple solution. Things that make sense are not very easy to do, just because everybody gets so entrenched in what they do. Administration does administration, clinicians do clinics, and patients are just there to get the care. There isn’t a whole lot of conversation between these two groups. So in my mind, the top priority would be to just get that communication going.

The physician-patient relationship, on one side, is suffering because physicians are so overwhelmed by all the workload, clinicians in general, not just physicians. And administrators are so overwhelmed by trying to meet the demand and not having the supply. And patients are just stuck in the middle, and they don’t have an out, and they don’t have a way to express or interact with those communities. And I think having a community mindset between all these groups would be one of the first steps.

We can’t be doing things in silos. We can’t be doing things that we only think are important. If we talk to each other, we’ll find a lot of common ground, and we’ll find a lot of ways that we can contribute, because the way to solve most of the things that we’re suffering from now is there. And the people who can solve it all are there. They just don’t talk to each other.

Kevin Pho: So Wael, talk about the frustration from a physician standpoint where these silos still exist, and the physicians and the administrators, they actually don’t take that community mindset. Talk about how that can contribute to some of the obstacles in you giving the best care you possibly could to patients.

Wael Saasouh: I think it’s all in the mindset. If we silo so much, then automatically we start feeling like we are right and everybody else is wrong. We are the people who are trying to do the best, and then everybody else, we demonize everybody else because they think differently or they have different priorities. Whereas it’s not so clear-cut. The priorities are eventually all the same. We have to take care of patients and give them the best care.

This involves physicians as well as other people, so administrators, assist personnel, everybody. If you’re the best physician on Earth and you’re in an area where there’s not enough access to care, there’s not much you can do, and vice versa. So the biggest problem, I feel, is everybody is having their individual mindset, not really contributing to the community.

Kevin Pho: So Kim, after hearing Wael’s story and Lisa’s story, what’s some of the connective tissue that brings them together in terms of addressing physician burnout? You’ve talked to so many clinicians about this. What specifically about Lisa and Wael, about their stories, brings them together in this conversation?

Kim Downey: Well, Wael’s involved in so many different things. He’s an actively practicing physician, and he’s a health care leader, and he’s a researcher and an entrepreneur. And I have such admiration and respect for him. And Lisa led our Medicine Forward retreat, and it was quite an undertaking, and Lisa did an incredible job. And I appreciate that they’re both optimistic and positive in a practical way. And we all have an understanding of the issues facing health care from multiple perspectives, and we’re driven toward positive change while seeking to understand the challenges of others versus placing blame, as Wael alluded to.

And Wael and Lisa had never met, and I wanted them both to be on my YouTube channel. And they requested to Zoom, and they even started a Google document to prepare. So they’re both just so organized and dedicated and committed. And then after they were on, they felt some synergy, and they expressed interest in collaborating further. And I said I had an idea on how we could do that, and here we are.

Kevin Pho: I think one thing that you said, Kim, that really resonates, that we have to solve this from different perspectives, of course, right? Wael, from your perspective as physician, and Lisa, your perspective from health care leadership. Lisa, you mentioned about the importance of what you call relational leadership and human flourishing, right? So talk more about these characteristics, and how can health care leaders implement these characteristics to help some of the problems that you’re describing?

Lisa Scardina: There’s a great example from a few years ago when I was part of the medical group in the Oregon region. We did a pilot. We called it the compassion initiative. We had some clinics that were our control group, kind of carried on with business as usual. We had another group of clinics that took an hour every other week to bring the teams together to talk about how things were going, some difficult patients in the clinic, the impact across the clinic, different roles, the MAs, the physicians, the front office staff.

And what we found was taking that one hour every other week really led to an improvement in overall patient satisfaction. Engagement scores went up. Productivity went up. Just a little bit of time, and not just unscripted time. I think it’s more structured conversations that are really meant to open up open and honest dialog across the team. Really was quite impactful.

And I think that really kind of set me on a course to think about how small tests of change, really, if there’s enough of those in order to help inform and provide results, demonstrated results, that’s an example, I think, of kind of some of those principles from relational leadership. Just opening up, creating a safe space, psychological safety, and allowing teams to have some open and honest conversations in the midst of really busy schedules and a lot of pressure. How do we respond to that by kind of recentering on the importance of human connection?

Kevin Pho: And Lisa, are you seeing this approach as part of a broader trend when it comes to health care leaders trying to address physician burnout, or is it something that’s unique to your particular institution?

Lisa Scardina: I do. I mean, I do think it’s a trend. One of the things through Medicine Forward that Kim and I are working on is with the upcoming Health Care Burnout Symposium in New York, November 20. Medicine Forward has some time to host a workshop where we’re inviting physicians, patients, others in to really explore how to deepen human connection in health care.

And so I think that’s where we’re seeing this trend toward some of what Wael was speaking to, of kind of that more community-connected, collaborative conversation happening across the different settings within health care and with patients. And so that’s just one example where I think that. But when we look out, there’s little glimmers of activity within organizations, within these physician and patient advocacy groups, and I do think that there’s a real positive momentum in this direction.

Kevin Pho: Wael, as Kim said, you’ve worn many hats. You’re, of course, a physician, health care leader, entrepreneur. So when it comes to physician burnout, you did mention that power of community. What other successful techniques have you seen from your perspective that have moved the needle when it comes to physician burnout? Because it seems like we’ve been talking about this issue for many, many years now, and while I think the needle has moved, it hasn’t moved as far as I would like to see. So Wael, what have you seen work from just your different hats in those different areas?

Wael Saasouh: I completely agree. The needle has moved, but not. It’s far from enough. And what I’ve seen from multiple employers, the ones that actually succeed in trying to alleviate a little bit of that burnout are the ones that are more interested in the personal story of the physicians and organize social gatherings, organize times when people can sit down and talk about something other than work.

The every-other-week, one-hour session that Lisa was talking about, that’s something that takes people out of their day-to-day grind and then puts them in a different mindset. And they start talking to each other like human beings, not like co-workers who have a list of things that they need to get done.

And one of the things, I think probably the most effective thing, would be empathy from both ends. Because it’s not just that the leadership is trying to get the clinicians to work. The clinicians also have relationships with the leadership. And if that relationship is more personal, a little bit more personal, in a way that focuses on the physician’s home life, the physician’s well-being. Are they sleeping OK? Are they eating OK? Do they have the facilities and the hospitals? Same thing when it comes to the leaders, because a burned-out leader is going to burn out the entire team. So this empathy, this connection, this emotional connection between leaders and clinicians, I think, is important.

Kevin Pho: So Wael, you talk about that empathy, and we always talk about the empathy that we think administrators should have for physicians. How about physicians’ empathy for some of the stresses and obstacles that administration has to go through? Because I think that they have their own certain set of goals that physicians may not be aware of. So talk about the empathy physicians can have towards their health care administration.

Wael Saasouh: Absolutely. And this falls into the silo-thinking idea, where physicians across the board mostly think that administrators are just there to make money and to work them to the B. And administrators think that physicians are just nagging too much and they have too many complaints. And there’s a lot of nuances to that. And getting a glimpse into each other’s lives would probably be helpful, where the administrator is sitting in one state and the clinician is in a different state, and they have no idea what each other are doing. And that doesn’t help. That doesn’t help humanize the other person.

So organizing face-to-face events, activities, even work meetings, where it’s, “I see what you’re doing. I see what you have to be done, and I can understand the stress that you’re under. Let’s find a way that we both come out winning from the situation.”

Kevin Pho: We’re talking about the KevinMD article “Fighting burnout with deeper human connections.” Now I’m going to ask each of you just to share some take-home messages that you want to leave with the KevinMD audience. Kim, why don’t you go first?

Kim Downey: Sure. Since we’re talking about deeper human connections today, my takeaway is going to be about LinkedIn. And you know what they say on social media about putting down your phone, that social media isn’t real life. So last year, as I was becoming active on LinkedIn, I had very mixed feelings about it. And I talked to my phys coach, Dr. Michael H, because I was honestly confused. I was questioning whether my time and relationships on LinkedIn were real life. And Michael asked me if that was true and if I had any evidence that the opposite was also true.

So that got me thinking. And a year later, there’s no doubt it’s real life. And I’ve met up with sixteen of my LinkedIn doctor friends in real life so far, a couple of them twice, and a handful of others, from here in Connecticut to Rhode Island, Long Island, New Jersey, D.C., North Carolina, West Virginia, Michigan, and most recently all the way in Ireland.

And human connections, as we know, are so important, and they won’t happen by passive scrolling. I’ll just reach out. And if I saw Wael’s profile on there, I would say, “Wow,” and maybe something I honestly admire about him, and I’ll reach out, and that’s how it’s happening. And also, don’t feel bad if someone doesn’t connect with you, because they might be afraid. It doesn’t necessarily mean anything about you. You just have to be a little willing to be a little vulnerable and put yourself out there, and beautiful things will happen.

Kevin Pho: Lisa, please share some of your take-home messages.

Lisa Scardina: Sure. I think my take-home message would be that what I find is taking a small step to open up a conversation with a colleague, with others. This is a big, complex issue, burnout in health care, all of the things that we’re talking about. And just making a small step to engage with others, as Kim’s describing, whether it be in some of the programming that Medicine Forward is doing, whether it be locally with your team, whether it just be raising a suggestion within your local leadership group.

I think working from a place of possibility and supporting yourself individually to get to a place where you feel like you have the energy for that. I mean, it’s one small step at a time, and I think it’s important to take a step.

Kevin Pho: And Wael, we’ll end with you. Please share your take-home messages.

Wael Saasouh: I think it’s very important for everybody to keep their why in mind. Why did they get into this whole thing in the beginning, and what keeps them connected to what they do? It’s fairly easy to get lost in the day-to-day work and forget about why you’re doing this and forget your emotional connection to your job, to your career, to the people around you. And that goes for everybody, not one side versus the other.

And adopting that community mindset would help in the long run, because all the expertise is here. Everybody who can fix these situations is already there and is already maybe working on something on their own. But put all those minds together, and then you get a solution.

Kevin Pho: Everybody, thank you so much for sharing your perspective and insight, and thank you all for coming on the show.

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